Carlos Antonio Rivero, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

104466 Issued in CA

Practice address

5625 Ruffin Rd Ste 200
San Diego, CA 92123-6392

Phone

(858) 569-9651

NPI assigned

Dec 1, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• I Zak DDS Prof Dental Corp

  • Dentist
  • Downey, CA
  • NPI 1588901979
  Medicare reassignment NPD
• Rivero DMD, Inc

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1245987080
  NPD Authorized official
• I Zak DDS Prof Dental Corp

  • Dentist
  • Simi Valley, CA
  • NPI 1174263974
  NPD
• I Zak DDS Prof Dental Corp

  • Dentist
  • Temecula, CA
  • NPI 1386163483
  NPD
• I Zak DDS Prof Dental Corp

  • Dentist
  • San Diego, CA
  • NPI 1922748755
  NPD

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1942502596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5023 AUGUST ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921101204",
            "telephone_number": "407-923-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 RUFFIN RD STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921236392",
            "telephone_number": "858-569-9651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 E Michigan St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328064537",
            "country_code": "US",
            "telephone_number": "407-250-4832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERO",
        "first_name": "CARLOS",
        "middle_name": "ANTONIO",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-01",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19106",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "104466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003965000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valeria Valentina Rivera, RBT
• Vanessa Rivera
• Vanessa Michelle Rivera, LMFT
• Yuriko Rivera
• Rivero DMD, Inc
• Adreena Rivers
• Denise Rivers
• Lynette Rivers
• Ruth W Rivers, PHARMD
• Pierre G. Rivet, MD

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.