Provider Demographics
NPI:1093270399
Name:SARMENTO, RODRIGO (DMD, MD)
Entity type:Individual
Prefix:
First Name:RODRIGO
Middle Name:
Last Name:SARMENTO
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11629 SOUTHCREST LN
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28134-9157
Mailing Address - Country:US
Mailing Address - Phone:727-656-4827
Mailing Address - Fax:
Practice Address - Street 1:12312 COPPER WAY STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-4856
Practice Address - Country:US
Practice Address - Phone:704-541-6070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXBP10081062390200000X
NC134411223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program