NPIMap

Organization Active NPI

Rafael Rivera, Jr., DDS, PLLC

Doing business as Smile Starters

  • Dentist
  • Winston Salem, NC
National Provider Identifier
1164690400
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
RAFAEL RIVERA, JR., DDS, PLLC
Doing business as
Smile Starters
Practice address
2041 Silas Creek Pkwy
Winston Salem, NC 27103-5147
Phone
(336) 777-1272
Fax
(336) 777-1196
NPI assigned
Feb 20, 2008
Last updated
Apr 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Authorized official

Name
Mrs. Maureen Shiroma
Title
Director of Office Managers
Phone
(336) 747-1523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

2041 Silas Creek Pkwy
Winston Salem, NC 27103-5147

Mailing address

PO Box 26394
Winston Salem, NC 27114-6394
Phone (336) 747-1523

Other names 1

  • Smile Starters Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Rafael Rivera Jr DDS PLLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1164690400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26394",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271146394",
            "telephone_number": "336-747-1523",
            "fax_number": "704-398-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 SILAS CREEK PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035147",
            "telephone_number": "336-777-1272",
            "fax_number": "336-777-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAFAEL RIVERA, JR., DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "SHIROMA",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_title_or_position": "DIRECTOR OF OFFICE MANAGERS",
        "authorized_official_telephone_number": "336-747-1523",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Starters",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.