Healthcare Provider Details
I. General information
NPI: 1699115048
Provider Name (Legal Business Name): HILMA KAREN RODRIGUEZ D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/30/2013
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
707 E MILL RD STE 101
VINEYARD UT
84059-5732
US
IV. Provider business mailing address
707 E MILL RD STE 101
VINEYARD UT
84059-5732
US
V. Phone/Fax
- Phone: 415-225-0696
- Fax: 385-283-0660
- Phone: 415-225-0696
- Fax: 385-283-0660
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0221X |
| Taxonomy | Pediatric Dentistry |
| License Number | 12645165 |
| License Number State | UT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 12645165 |
| License Number State | UT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: