MEDICARE: DR. ADAM PATRICK RODRIGUEZ DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	S6-239	NV

General Provider Information

NPI Number	:	1629630496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM PATRICK RODRIGUEZ DDS

Provider Business Mailing Address
First Line	:	955 W CRAIG RD STE 106
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-0279
Country	:	US
Telephone Number	:	909-568-9232
Fax Number	:

Provider Business Practice Location Address
First Line	:	955 W CRAIG RD STE 106
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-0279
Country	:	US
Telephone Number	:	702-522-2272
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2019
Last Update Date	:	11/22/2025

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