| Dr Jose Carlos Rodriguez, DDS | |
|
East Highway 18, Pine Ridge, SD 57770-1201 | |
| (605) 867-3078 | |
| (605) 867-3229 |
| Full Name | Dr Jose Carlos Rodriguez |
|---|---|
| Gender | Male |
| Speciality | Dentist - General Practice |
| Location | East Highway 18, Pine Ridge, South Dakota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467425926 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 001871 (Puerto Rico) | Primary |
| Entity Name | Pine Ridge Indian Health Service Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1497786412 PECOS PAC ID: 4688571326 Enrollment ID: O20031218000966 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jose Carlos Rodriguez, DDS 6606 150th Ln, Gordon, NE 69343-5407 Ph: (308) 282-0779 | Dr Jose Carlos Rodriguez, DDS East Highway 18, Pine Ridge, SD 57770-1201 Ph: (605) 867-3078 |
Dr. Gary C. Stormo, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: East Highway 18, Pine Ridge, SD 57770 Phone: 605-867-3078 Fax: 605-867-3229 |
Dr. Ryan Baxter, DMD Dentist Medicare: Medicare Enrolled Practice Location: 607 Indian Health Rd, Pine Ridge, SD 57770 Phone: 605-867-5131 |