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General NPI Number Information
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NPI Number | 1023491248
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Entity Type | Individual
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Provider Name | LORRAINE RODRIGUEZ DDS
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Gender | Female
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 03/29/2017
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Provider Practice Location Address
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Address Line | 2970 BELCREST CENTER DRIVE STE 105 IBRUSH FAMILY DENTAL CARE
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City | HYATTSVILLE
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State | MD
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Zip | 20782-1912
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Country | US
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Telephone | 786-205-1900
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Fax |
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Provider Business Mailing Address
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Address Line | HOWARD UNIVERSITY HOSPITAL 2041 GEORGIA AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20060-0001
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Country | US
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Telephone | 786-205-1900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 15968
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License Number State | MD
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