Organization Active NPI

Carlos Rivas D.D.S.,Inc.

  • General Practice Dentistry
  • Moreno Valley, CA
National Provider Identifier
1366787004
Registry record updated Dec 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CARLOS RIVAS D.D.S.,INC.
Practice address
24430 Alessandro Blvd
104
Moreno Valley, CA 92553-2435
Phone
(951) 601-0350
Fax
(951) 601-0325
NPI assigned
Dec 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2012

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

Authorized official

Name
Dr. Carlos Alberto Rivas, DDS
Title
Dentist
Phone
(951) 601-0350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

24430 Alessandro Blvd
104
Moreno Valley, CA 92553-2435

Mailing address

24430 Alessandro Blvd
104
Moreno Valley, CA 92553-2435
Phone (951) 601-0350

National Provider Directory

National Provider Directory

Locations

24430 Alessandro Blvd
Ste 104
Moreno Valley, CA 92553
Phone (951) 601-0350

Practitioners & affiliated clinicians

Practitioners 1

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": "1354752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354752000000",
    "number": "1366787004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24430 ALESSANDRO BLVD",
            "address_2": "104",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925532435",
            "telephone_number": "951-601-0350",
            "fax_number": "951-601-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24430 ALESSANDRO BLVD",
            "address_2": "104",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925532435",
            "telephone_number": "951-601-0350",
            "fax_number": "951-601-0325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOS RIVAS D.D.S.,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-06",
        "last_updated": "2012-12-06",
        "status": "A",
        "authorized_official_last_name": "RIVAS",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "ALBERTO",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "951-601-0350",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; 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.