=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629630496
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ADAM PATRICK RODRIGUEZ DDS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/02/2019
-----------------------------------------------------
Last Update Date | 11/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 955 W CRAIG RD STE 106
-----------------------------------------------------
City | NORTH LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89032-0279
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-522-2272
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 955 W CRAIG RD STE 106
-----------------------------------------------------
City | NORTH LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89032-0279
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-568-9232
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0221X
-----------------------------------------------------
Taxonomy Name | Pediatric Dentistry
-----------------------------------------------------
License Number | S6-239
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------