Ethan Roderick

Dentist · Jbsa Lackland, TX

Individual Active NPI

NPI number 1780518340

Practice location

1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638
Phone
(210) 292-4277

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NPI record

NPI
1780518340
Entity type
Individual (Type 1)
Enumeration date
June 10, 2026
Last updated
July 6, 2026
Certified
July 6, 2026
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X DB-2026-0191 NM

Other practice locations (1)

  • 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 · (210) 916-7500

About Ethan Roderick

Ethan Roderick is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638. The NPI number 1780518340 was assigned on June 10, 2026 and the record was last updated on July 6, 2026.

Ethan Roderick lists a license in the registry: #DB-2026-0191 (NM) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Ethan Roderick?

The NPI number is 1780518340.

What is the phone number of Ethan Roderick?

The phone number listed for the practice location is (210) 292-4277.

Where is Ethan Roderick located?

1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638.

What is the taxonomy code for Ethan Roderick?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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