Active NPI
Guillermo Rivacoba, DDS
- General Practice Dentistry
- Waco, TX
National Provider Identifier
1285204826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 37385
- Practice address
- 113 Burnett CT
Waco, TX 76712-3100 - Phone
- (254) 776-3310
- NPI assigned
- Jun 27, 2021
- Last updated
- Jun 27, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 37385 | TX | Primary |
Addresses
Primary practice location
113 Burnett CT
Waco, TX 76712-3100
Mailing address
721 Austin Ave Apt 1
Waco, TX 76701-2056
Phone (210) 371-4908
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
| License | State | Type | Specialty |
|---|---|---|---|
| 37385 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hot Smiles PLLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1624752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624752000000",
"number": "1285204826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "721 AUSTIN AVE APT 1",
"city": "WACO",
"state": "TX",
"postal_code": "767012056",
"telephone_number": "210-371-4908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 BURNETT CT",
"city": "WACO",
"state": "TX",
"postal_code": "767123100",
"telephone_number": "254-776-3310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVACOBA",
"first_name": "GUILLERMO",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-27",
"last_updated": "2021-06-27",
"certification_date": "2021-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "37385",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.