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General NPI Number Information
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NPI Number | 1578304200
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Entity Type | Individual
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Provider Name | XENIA RODRIGUEZ DDS
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Gender | Female
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 328 BUSINESS PARK DR
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City | CHINO VALLEY
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State | AZ
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Zip | 86323-5765
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Country | US
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Telephone | 928-636-6972
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Fax |
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Provider Business Mailing Address
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Address Line | 3131 N MAIN ST APT C311
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-2399
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Country | US
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Telephone | 978-495-2806
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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 | D012185
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License Number State | AZ
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