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General NPI Number Information
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NPI Number | 1538096193
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Entity Type | Individual
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Provider Name | LARISSA N RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 05/07/2026
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Last Update Date | 05/07/2026
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Provider Practice Location Address
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Address Line | 1200 E WEST HWY # 3
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City | SILVER SPRING
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State | MD
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Zip | 20910-8200
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Country | US
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Telephone | 240-534-1661
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Fax |
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Provider Business Mailing Address
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Address Line | 650 REALM CT W
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City | ODENTON
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State | MD
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Zip | 21113-1559
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Country | US
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Telephone | 301-674-3569
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 9292
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License Number State | MD
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