Rivero DMD, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

RIVERO DMD, INC

Doing business as

The Dental Extraction Clinic

Practice address

3560 Fairmount Ave Ste B
San Diego, CA 92105-3420

Phone

(619) 877-0124

NPI assigned

Mar 2, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Carlos Antonio Rivero, DMDNPI 1942502596

Title

Director

Phone

(407) 923-7433

Specialties & licenses 1

Addresses

Other names 1

• The Dental Extraction Clinic Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carlos Antonio Rivero, D.M.D.

  • Dentist
  • San Diego, CA
  • NPI 1942502596
  NPD Authorized official
• Shahrzad Prater, D.M.D

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chula Vista, CA
  • NPI 1912164468
  NPD (past)

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743465600000",
    "number": "1245987080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5023 AUGUST ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921101204",
            "telephone_number": "407-923-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 FAIRMOUNT AVE STE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921053420",
            "telephone_number": "619-877-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERO DMD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A",
        "authorized_official_last_name": "RIVERO",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "407-923-7433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Dental Extraction Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tiffany Nellene Rivera, HHP
• Valeria Valentina Rivera, RBT
• Vanessa Rivera
• Vanessa Michelle Rivera, LMFT
• Yuriko Rivera
• Carlos Antonio Rivero, D.M.D.
• Adreena Rivers
• Denise Rivers
• Lynette Rivers
• Ruth W Rivers, PHARMD

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, 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 Apr 1, 2025; 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.