Provider Demographics
NPI:1366401762
Name:RODEK, ALINA (DDS)
Entity type:Individual
Prefix:DR
First Name:ALINA
Middle Name:
Last Name:RODEK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 SINGERLY RD
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-2739
Mailing Address - Country:US
Mailing Address - Phone:410-398-3833
Mailing Address - Fax:410-398-3833
Practice Address - Street 1:2204 SINGERLY RD
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-2739
Practice Address - Country:US
Practice Address - Phone:410-398-3833
Practice Address - Fax:410-398-3833
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0520861223G0001X
MD152691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02688755Medicaid