NPIMap

Organization Active NPI

Rafael Rivera, Jr., DDS, PLLC

  • Dentist
  • Fayetteville, NC
National Provider Identifier
1285803197
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
RAFAEL RIVERA, JR., DDS, PLLC
Doing business as
SmileStarters
Practice address
1400 Walter Reed Rd
Fayetteville, NC 28304-4409
Phone
(910) 864-9884
Fax
(910) 354-1399
NPI assigned
Feb 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Authorized official

Name
Mrs. Maureen Shiroma
Title
Director of Office Managers
Phone
(336) 747-1523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1400 Walter Reed Rd
Fayetteville, NC 28304-4409

Mailing address

PO Box 26394
Winston Salem, NC 27114-6394
Phone (704) 816-1401

Other names 1

  • SmileStarters Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Rafael Rivera Jr DDS PLLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1400 Walter Reed Rd
Fayetteville, NC 28304
Phone (910) 864-9884

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1285803197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26394",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271146394",
            "telephone_number": "704-816-1401",
            "fax_number": "704-398-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 WALTER REED RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044409",
            "telephone_number": "910-864-9884",
            "fax_number": "910-354-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAFAEL RIVERA, JR., DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-25",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "SHIROMA",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_title_or_position": "DIRECTOR OF OFFICE MANAGERS",
        "authorized_official_telephone_number": "336-747-1523",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SmileStarters",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.