Angel Ivan Rivera, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

36381 Issued in TX

Practice address

2780 Highway 365 Ste C
Port Arthur, TX 77640-2191

Phone

(409) 332-4701

NPI assigned

Jul 22, 2020

Last updated

Jul 22, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1083222392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7606 MARINETTE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770744750",
            "telephone_number": "713-419-9775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 HIGHWAY 365 STE C",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776402191",
            "telephone_number": "409-332-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "ANGEL",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-22",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "36381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Residential Senior Care (RSC)
• Reyna Nguyen D.D.S P.L.L.C
• Heather Nicole Rhodes, DDS
• Richard a Schleiffer DPM Apc
• Todd Randall Rippy, P.T.A.
• Judith Lynn Rivers, PTA
• Corey John Rizzo, DC
• Robert T. Warhola, D.O., P.a
• Chalita La Shon Roberts, PTA
• Gregory Lee Roberts, R.PH.

• Dentist in Port Arthur, TX
• Providers in Port Arthur, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.