Keyshla Yari Escobar Rivera, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

36113 Issued in TX

Practice address

1317 W Davis St Ste D
Conroe, TX 77304-2334

Phone

(936) 760-2400

NPI assigned

Mar 7, 2019

Last updated

Jun 11, 2021By 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 2

Addresses

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.

• Keysmiles LLC

  • General Practice Dentistry
  • Conroe, TX
  • NPI 1396604062
  NPD Authorized official

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1548728728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3203 DEEP RIVER CT",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773393621",
            "telephone_number": "787-244-7727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 W DAVIS ST STE D",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042334",
            "telephone_number": "936-760-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "800-636-6683",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25114 Grogans Mill Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "773802360",
            "country_code": "US",
            "telephone_number": "281-296-7600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESCOBAR RIVERA",
        "first_name": "KEYSHLA",
        "middle_name": "YARI",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "36113",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Enochs
• Ihuoma Chinagorom Enyidede
• Ep-Cardiology PA
• Lana Kate Erickson
• Steffani Elise Erickson, BCBA, LBA
• Tina Cheryl Escoyne, FNP-BC, ACNP-BC
• Isaac Esparza
• Niurka Espinosa-Varona I, RBT
• Julissa Espinoza, PHD, LPC-S
• Kimberly Raabe Espinoza, DDS

• General Practice Dentistry in Conroe, TX
• Providers in Conroe, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.