Louis Raul Rivera, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD1537 Issued in NM

Practice address

4824 McMahon Blvd NW
Suite 105
Albuquerque, NM 87114-5412

Phone

(505) 890-1911

Fax

(505) 890-5014

NPI assigned

Feb 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

State licenses

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477528511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4824 MCMAHON BLVD NW",
            "address_2": "SUITE 105",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145412",
            "telephone_number": "505-890-1911",
            "fax_number": "505-890-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 MCMAHON BLVD NW",
            "address_2": "SUITE 105",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145412",
            "telephone_number": "505-890-1911",
            "fax_number": "505-890-5014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "LOUIS",
        "middle_name": "RAUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD1537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kassandra Ylissa Rivera, LMSW
• Kelly Dawn Rivera, CPSW
• Kelly Vanessa Rivera, APRN-CNP
• Kristin Mary Rivera, BSN, MSN, NP-C
• Lisa M Rivera, LMT
• Margo J Rivera, LPCC
• Martin Louis Rivera, LMT
• Michelle Marie Rivera
• Miquela Carleen Rivera, PH.D.
• Monique Rivera

• General Practice Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.