Provider Demographics
NPI:1760856512
Name:RODRIGUEZ, KAITLIN BENCHIMOL (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAITLIN
Middle Name:BENCHIMOL
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 1:167 OAKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-1497
Mailing Address - Country:US
Mailing Address - Phone:727-698-2881
Mailing Address - Fax:
Practice Address - Street 1:9181 GLADES RD STE 120
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3940
Practice Address - Country:US
Practice Address - Phone:561-558-9467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-17
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA651451223P0221X
FL249461223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry