Provider Demographics
NPI:1811001522
Name:RODRIGUES, SHWETHA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHWETHA
Middle Name:
Last Name:RODRIGUES
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 1:12517 JEFFERSON DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-5307
Mailing Address - Country:US
Mailing Address - Phone:804-748-2555
Mailing Address - Fax:804-748-6468
Practice Address - Street 1:12517 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-5307
Practice Address - Country:US
Practice Address - Phone:804-748-2555
Practice Address - Fax:804-748-6468
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014108191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice