Individual provider Active NPI

Mario E Rivera, DMD

  • Dentist
  • Naranjito, PR
National Provider Identifier
1669402186
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2067 Issued in PR
Practice address
HC 72 Box 3512
Naranjito, PR 00719-9716
Phone
(787) 869-0057
NPI assigned
Jul 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2067 PR Primary

Addresses

Primary practice location

HC 72 Box 3512
Naranjito, PR 00719-9716

Mailing address

524 Camino Estrella
Vega Baja, PR 00693-4181
Phone (787) 858-4146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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

Enrollment IDStateProvider typePAC IDDetails
I20150708002740 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4082926720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669402186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 CAMINO ESTRELLA",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006934181",
            "telephone_number": "787-858-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 72 BOX 3512",
            "city": "NARANJITO",
            "state": "PR",
            "postal_code": "007199716",
            "telephone_number": "787-869-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "MARIO",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "2067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naranjito, PR

Sources for this page

Verify at the official NPI Registry.