Individual provider · Type 1 NPI

Ethan Roderick

Dentist · Jbsa Lackland, TX

NPI number 1780518340 Active

Practice location

1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638

Call (210) 292-4277 Map

Other practice locations

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

Specialties and licenses

TaxonomyCodeLicense
Dentist Primary 122300000XDB-2026-0191 (NM)

Dentist: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requiremen…

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About NPI 1780518340

Ethan Roderick's National Provider Identifier is 1780518340, issued on Jun 10, 2026. The primary taxonomy on file is Dentist (122300000X), and the practice location is in Jbsa Lackland, TX. The record was last updated on Jul 6, 2026.