Healthcare Provider Details

I. General information

NPI: 1699690073
Provider Name (Legal Business Name): RODRIGO F RANGEL DDS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 HARVARD ST
BROOKLINE MA
02445-7904
US

IV. Provider business mailing address

136 BABCOCK ST APT 214
BROOKLINE MA
02446-5975
US

V. Phone/Fax

Practice location:
  • Phone: 617-651-3644
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. RODRIGO FERNANDEZ RANGEL
Title or Position: PERIODONTIST
Credential: DDS, MS, MMSC
Phone: 248-535-6195