Provider Demographics
NPI:1437169927
Name:RODRIGUEZ, ESPERANZA A (DDS)
Entity type:Individual
Prefix:DR
First Name:ESPERANZA
Middle Name:A
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ESPERANZA
Other - Middle Name:
Other - Last Name:MCPARTLAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2406 WALTON AVE
Mailing Address - Street 2:DENTAL OFFICE
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-6454
Mailing Address - Country:US
Mailing Address - Phone:718-364-7791
Mailing Address - Fax:718-364-4135
Practice Address - Street 1:2406 WALTON AVE
Practice Address - Street 2:DENTAL OFFICE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-6454
Practice Address - Country:US
Practice Address - Phone:718-364-7791
Practice Address - Fax:718-364-4135
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0503261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02361466Medicaid