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NPI Code Detail

MEDICARE: DR. SMITA JOCKIM RODRIGUES D.D.S.

MEDICARE: DR. SMITA JOCKIM RODRIGUES D.D.S.
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
11223G0001XGeneral Practice Dentistry48986CA
2122300000XDentist48986CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11679826481OTHERNPI TYPE II

General Provider Information

NPI Number : 1730377425
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SMITA JOCKIM RODRIGUES D.D.S.
Provider Business Mailing Address
First Line : 2344 EL CAMINO REAL
Second Line : SUITE-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 : SUITE-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 :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2007
Last Update Date : 04/09/2022

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1679826481 — SMITA J RODRIGUES DDS INC.
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2344 EL CAMINO REAL , STE-120
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Practice Phone: 408-260-0770
Practice Fax: 408-260-0680

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