Provider Demographics
NPI:1962874651
Name:RODRIGUEZ, ANDREA B (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:B
Last Name:RODRIGUEZ
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 1:1718 1ST ST NW
Mailing Address - Street 2:APT 8
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-1140
Mailing Address - Country:US
Mailing Address - Phone:240-423-8222
Mailing Address - Fax:
Practice Address - Street 1:11251 LOCKWOOD DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-4556
Practice Address - Country:US
Practice Address - Phone:301-754-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD160811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice