Individual provider Active NPI

Michelle Rivera, DMD

  • General Practice Dentistry
  • Deerfield Beach, FL
National Provider Identifier
1306944996
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN17012 Issued in FL
Practice address
313 SE 15TH Ter
Deerfield Beach, FL 33441-4472
Phone
(954) 427-7513
Fax
(954) 427-7676
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 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 DN17012 FL Primary

Addresses

Primary practice location

313 SE 15TH Ter
Deerfield Beach, FL 33441-4472

Mailing address

313 SE 15TH Ter
Deerfield Beach, FL 33441-4472
Phone (954) 427-7513

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
DN17012FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Dental of East Deerfield Beach PLLC CurrentSince Feb 1, 2022 Accepting new patients

Locations

313 SE 15th Ter
Deerfield Beach, FL 33441
Phone (954) 427-7513

Networks

  • Freedom Health HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1306944996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 SE 15TH TER",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334414472",
            "telephone_number": "954-427-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 SE 15TH TER",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334414472",
            "telephone_number": "954-427-7513",
            "fax_number": "954-427-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.