Individual provider Active NPI

Yvette Rivera, DMD

  • General Practice Dentistry
  • Upland, CA
National Provider Identifier
1265589527
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
53455 Issued in CA
Practice address
1042 N Mountain Ave Ste A2
Upland, CA 91786-3695
Phone
(909) 579-0623
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 53455 CA Primary

Addresses

Primary practice location

1042 N Mountain Ave Ste A2
Upland, CA 91786-3695

Mailing address

1042 N Mountain Ave Ste A2
Upland, CA 91786-3695
Phone (909) 579-0623

Other practice location 1

424 S Main St
Ste H
Orange, CA 92868-3824
Phone (714) 639-1922

Other names 1

  • Dr. Yvette Gutierrez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
53455CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Russel R. Nolasco DDS, Inc General Practice CurrentSince Jan 21, 2024 Accepting new patients
Cox Dental Corporation General Practice PastSince Dec 29, 2019 Accepting new patients
Yvette Rivera DMD Inc General Practice PastSince Jul 10, 2022 Accepting new patients

Locations

1042 N Mountain Ave
Ste A2
Upland, CA 91786
Phone (909) 579-0623

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1265589527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1042 N MOUNTAIN AVE STE A2",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863695",
            "telephone_number": "909-579-0623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1042 N MOUNTAIN AVE STE A2",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863695",
            "telephone_number": "909-579-0623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "424 S Main St",
            "address_2": "Ste H",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683824",
            "country_code": "US",
            "telephone_number": "714-639-1922",
            "fax_number": "714-634-1962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "YVETTE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YVETTE",
            "last_name": "GUTIERREZ",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.