Grace C Rivera, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48364 Issued in CA

Practice address

4847 Lone Tree Way Ste B
Antioch, CA 94531-8612

Phone

(925) 755-4040

Fax

(925) 755-4041

NPI assigned

Jul 5, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Grace Cabildo-Rivera Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Grace Cabildo-Rivera a Professional Dental Corporation

  dba new city dental practice

  • General Practice Dentistry
  • Antioch, CA
  • NPI 1215953112
  NPD (past) Authorized official

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528266160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 JOHNS WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318368",
            "telephone_number": "925-755-4040",
            "fax_number": "925-755-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4847 LONE TREE WAY STE B",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318612",
            "telephone_number": "925-755-4040",
            "fax_number": "925-755-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "GRACE",
        "middle_name": "C",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1332285",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY FAMILIES",
            "identifier": "B48364-01",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL",
            "identifier": "G93378-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "CABILDO-RIVERA",
            "credential": "D.D.S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Yolanda Rivas
• Crystal Rivera
• Debra Lynn Rivera, MS, RD
• Edgar Josue Rivera, LCSW
• Erick Rivera
• Imara Rivera
• Melissa Rivera, MS, CCC-SLP
• Dannielle Rivers
• RMD Services Inc. (Belle Home)
• Alexis Robbins

• General Practice Dentistry in Antioch, CA
• Providers in Antioch, CA by specialty
• General Practice Dentistry in California

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.