Healthcare Provider Details

I. General information

NPI: 1942122965
Provider Name (Legal Business Name): GRISELDA KARINA RODRIGUEZ DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 9TH ST STE 190
DES MOINES IA
50314-2527
US

IV. Provider business mailing address

2318 E 50TH ST
DES MOINES IA
50317-4870
US

V. Phone/Fax

Practice location:
  • Phone: 515-244-9136
  • Fax:
Mailing address:
  • Phone: 515-822-5049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number10534
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: