Jaclyn F Rivera, D.M.D

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN21806 Issued in FL

Practice address

13246 N Dale Mabry Hwy
Tampa, FL 33618-2408

Phone

(813) 926-6776

NPI assigned

Jun 3, 2013

Last updated

May 18, 2016By 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

Enrolled in FL

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": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1871930727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13246 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182408",
            "telephone_number": "813-926-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13246 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182408",
            "telephone_number": "813-926-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "JACLYN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-03",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN21806",
            "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": []
}

• Elizabeth Rivera, RBT
• Elizabeth Denise Rivera, FNP-C
• Evangelina Rivera, OTR
• Gilberto Rivera
• Grisel C Rivera
• Jamiqua Lucita Rivera
• Janellee Rivera
• Jesse Thomas Rivera, BA
• Jose J Rivera, M.D.
• Juan J Rivera, D.P.M.

• Endodontics in Tampa, FL
• Providers in Tampa, FL by specialty
• Endodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.