MEDICARE: RODERICK HENRY ADAMS JR. 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	1223G0001X	General Practice Dentistry	30.015634	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982770715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODERICK HENRY ADAMS JR. DDS

Provider Business Mailing Address
First Line	:	13922 CEDAR RD # 3
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-3204
Country	:	US
Telephone Number	:	216-721-0500
Fax Number	:	216-721-5775

Provider Business Practice Location Address
First Line	:	13922 CEDAR RD # 3
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-3204
Country	:	US
Telephone Number	:	216-721-0500
Fax Number	:	216-721-5775

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

Provider Enumeration Date	:	11/24/2006
Last Update Date	:	07/22/2024

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