Elias M Rivera, DDS, MS

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

0401417269 Issued in VA

Practice address

623 Garrisonville Rd
Stafford, VA 22554-3710

Phone

(540) 300-1248

NPI assigned

Jul 16, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1275888281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 GARRISONVILLE RD",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225543710",
            "telephone_number": "540-300-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 GARRISONVILLE RD",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225543710",
            "telephone_number": "540-300-1248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "ELIAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-16",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "VA",
            "license": "0401417269",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MD",
            "license": "17214",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alejandro Rios
• Katherin Rios
• Kalynda Leigh Ripley, RBT
• Rise Up Physical Therapy PC
• River Flow Cares LLC (Seniors Helping Seniors)
• Javier Antonio Rivera
• Mohammad Rizwan, DC
• Simone Roberts
• Rosalyn Masi Robertson, RD
• Nuru Abseno Robi, M.D.

• Prosthodontics in Stafford, VA
• Providers in Stafford, VA by specialty
• Prosthodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.