Grace Cabildo-Rivera a Professional Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48364 Issued in CA

Legal business name

GRACE CABILDO-RIVERA A PROFESSIONAL DENTAL CORPORATION

Doing business as

new city dental practice

Practice address

4847 Lone Tree Way Ste B
Antioch, CA 94531-8612

Phone

(925) 755-4040

Fax

(925) 755-4041

NPI assigned

Jul 14, 2006

Last updated

Oct 2, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Grace Cabildo Rivera, D.D.SNPI 1528266160

Title

Doctor/Owner

Phone

(925) 755-4040

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• new city dental practice Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Grace C Rivera, D.D.S

  • General Practice Dentistry
  • Antioch, CA
  • NPI 1528266160
  NPD (past) Authorized official

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222905600000",
    "number": "1215953112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4847 LONE TREE WAY STE B",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318612",
            "telephone_number": "925-755-4040",
            "fax_number": "925-755-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4847 LONE TREE WAY STE B",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318612",
            "telephone_number": "925-755-4040",
            "fax_number": "925-755-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE CABILDO-RIVERA A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2008-10-02",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "CABILDO",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "925-755-4040",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "1332285",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OLD TAX I.D NUMBER",
            "identifier": "341996792",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY FAMILIES PROVIDER",
            "identifier": "B48364-01",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G9337801",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "new city dental practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Larrese Gooden
• Ann Marie Gorczyca, D.M.D., M.P.H., M.S.
• Toby Gould, MFT
• Erika Goveia
• Ashul Govil, M.D.
• Cynthia Gracie
• Marvin Darnell Graddy
• John Louis Gragnani, MS,MA
• Kellie Graham, PPS
• Larry Christopher Graham Jr.

• General Practice Dentistry in Antioch, CA
• Providers in Antioch, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; 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.