Riverfamilydentalpresentedbydr.Manalsunnaddsllc

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

RIVERFAMILYDENTALPRESENTEDBYDR.MANALSUNNADDSLLC

Practice address

4163 Pearl Rd
28651 Touchstone Cir
Cleveland, OH 44109-3332

Phone

(440) 454-4878

Fax

(216) 862-3585

NPI assigned

Feb 8, 2017

Organization subpart

No

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

Authorized official

Name

Cathryn Buckner, DENTAL ASSITANT

Title

Office Manager

Phone

(216) 268-3060

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• River Family Dental Doing business as

Locations

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486512000000",
    "number": "1982142113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4163 PEARL RD",
            "address_2": "28651 TOUCHSTONE CIR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441093332",
            "telephone_number": "440-454-4878",
            "fax_number": "216-862-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4163 PEARL RD",
            "address_2": "28651 TOUCHSTONE CIR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441093332",
            "telephone_number": "440-454-4878",
            "fax_number": "216-862-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERFAMILYDENTALPRESENTEDBYDR.MANALSUNNADDSLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-08",
        "last_updated": "2017-02-08",
        "status": "A",
        "authorized_official_last_name": "BUCKNER",
        "authorized_official_first_name": "CATHRYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "216-268-3060",
        "authorized_official_credential": "DENTAL ASSITANT"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0066021",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Raynita M Rivera, QMHS-3YRS
• Robert Rivera
• Rozlyn Rivera
• Vilmary Aineliz Rivera
• Riveredge Dentistry Inc
• Autumn Marie Rivers
• Cheryl J Rivers, LSW
• Gwennita Rivers
• Jerome C. Rivers, LPCC-S, LIMFT
• Matthew Richard Rivers, D.C.

• Dentist in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; 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.