Individual
DR. KEVIN MANUEL RODRIGUEZ-LICHTENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MPH
Contact information
Practice address
6661 LAKE HARBOUR DR, MIDLOTHIAN, VA 23112-2082
(804) 729-0792
Mailing address
6661 LAKE HARBOUR DR, MIDLOTHIAN, VA 23112-2082
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401417104
VA
1223P0221X
Pediatric Dentistry
Primary
0401417104
VA
1223P0221X
Pediatric Dentistry
Primary
17358
MD
1223P0221X
Pediatric Dentistry
DN28821
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122877100
—
FL
Enumeration date
02/13/2020
Last updated
03/25/2026
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