DR. RUSSELL W RODERICK D.M.D NPI 1912013020

NPI Information

NPI: 1912013020
Provider Name: DR. RUSSELL W RODERICK, D.M.D
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

Address:
26232 N TATUM BLVD
SUITE 400
PHOENIX, AZ
ZIP 85050
Phone: (480) 515-0404
Get Directions

DR. Russell W Roderick, D.M.D is a general practice dentist in Phoenix, AZ. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Russell W Roderick, D.M.D NPI is 1912013020. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

26232 N TATUM BLVD
SUITE 400
PHOENIX, AZ
ZIP 85050-501
Phone: (480) 515-0404
Fax: (480) 515-2587

The enumeration date for this NPI number is 8/22/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	4906	ARIZONA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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