Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethan Roderick

Individual provider Dentist · NPI 1780518340

Ethan Roderick is a Dentist in Jbsa Lackland, Texas. Works from 2 locations. Licensed in New Mexico.

Licensed in
NM
In the registry since
2026

Practice location Address checks out

1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638
Phone: (210) 292-4277
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

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

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence DB-2026-0191 (NM)

Record details

NPI number1780518340
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 10, 2026
Last updated in NPPESJuly 6, 2026
Certification dateJuly 6, 2026
Mailing address1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638

Other providers in Jbsa Lackland