Provider Demographics
NPI:1043625569
Name:RIOS, LUISA NOEMI (DDS, MD)
Entity Type:Individual
Prefix:DR
First Name:LUISA
Middle Name:NOEMI
Last Name:RIOS
Suffix:
Gender:F
Credentials:DDS, MD
Other - Prefix:MISS
Other - First Name:LUISA
Other - Middle Name:NOEMI
Other - Last Name:CAMPOS ARAMBURO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MD
Mailing Address - Street 1:3302 GASTON AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2013
Mailing Address - Country:US
Mailing Address - Phone:214-820-8445
Mailing Address - Fax:
Practice Address - Street 1:3302 GASTON AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2013
Practice Address - Country:US
Practice Address - Phone:214-828-8445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30010122300000X, 1223S0112X
TXBP10060738208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist
No208600000XAllopathic & Osteopathic PhysiciansSurgery