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General NPI Number Information
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NPI Number | 1760856512
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Entity Type | Individual
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Provider Name | KAITLIN BENCHIMOL RODRIGUEZ DDS
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Gender | Female
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Dates
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Enumeration Date | 11/17/2015
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Last Update Date | 10/22/2020
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Provider Practice Location Address
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Address Line | 9181 GLADES RD STE 120
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City | BOCA RATON
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State | FL
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Zip | 33434-3940
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Country | US
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Telephone | 561-558-9467
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Fax |
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Provider Business Mailing Address
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Address Line | 167 OAKWOOD LN
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-1497
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Country | US
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Telephone | 727-698-2881
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 65145
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 24946
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License Number State | FL
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