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NPI Code Detail

MEDICARE: SMITA J RODRIGUES DDS INC.

MEDICARE: SMITA J RODRIGUES DDS INC.
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
1122300000XDentist48986CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11730377425OTHERTYPE I NPI

General Provider Information

NPI Number : 1679826481
Entity Type Code : Organization
Provider Name (Legal Business Name) : SMITA J RODRIGUES DDS INC.
Provider Business Mailing Address
First Line : 2344 EL CAMINO REAL
Second Line : STE-120
City : SANTA CLARA
State : CA
Zip : 95050-4072
Country : US
Telephone Number : 408-260-0770
Fax Number : 408-260-0680
Provider Business Practice Location Address
First Line : 2344 EL CAMINO REAL
Second Line : STE-120
City : SANTA CLARA
State : CA
Zip : 95050-4072
Country : US
Telephone Number : 408-260-0770
Fax Number : 408-260-0680
Authorized Official
Title or Position : PRESIDENT/CEO
Name : DR. SMITA J RODRIGUES
Credential : DDS
Telephone Number : 408-260-0770
Provider Enumeration Date : 10/17/2012
Last Update Date : 10/26/2012

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