Jonathan Rivera, N5

Primary specialty

Dental Laboratory TechnicianTaxonomy code 126900000X

Practice address

2605 Saint Mihiel St
Fort Irwin, CA 92310-1654

Phone

(615) 663-2003

NPI assigned

Oct 26, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1700398021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 SAINT MIHIEL ST",
            "city": "FORT IRWIN",
            "state": "CA",
            "postal_code": "923101654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 SAINT MIHIEL ST",
            "city": "FORT IRWIN",
            "state": "CA",
            "postal_code": "923101654",
            "telephone_number": "615-663-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "JONATHAN",
        "credential": "N5",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-26",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126900000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Charles Ransom, NP
• Diana Lea Read, R.N.
• Samantha Reineck, RDN
• Valvincent Abanilla Reyes, BCD, LCSW
• Austin Leon Ridgway Jr., MD
• Luis Raul Rivero, M.D., M.P.H.
• Ethel Lee Roberson, RN
• Roselva Mendoza Rosetelopez, RN
• Loretta Jean Rust, RN
• Mary Jee Jean Toledo Sabal, LPN

• Dental Laboratory Technician in Fort Irwin, CA
• Providers in Fort Irwin, CA by specialty
• Dental Laboratory Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; 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.