Provider Demographics
NPI:1033898911
Name:DANIELLE RIVERA DOI
Entity Type:Organization
Organization Name:DANIELLE RIVERA DOI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA DOI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:407-968-9265
Mailing Address - Street 1:2254 PENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526-1945
Mailing Address - Country:US
Mailing Address - Phone:585-377-1320
Mailing Address - Fax:
Practice Address - Street 1:2254 PENFIELD RD
Practice Address - Street 2:
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-1945
Practice Address - Country:US
Practice Address - Phone:585-377-1320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty