Provider Demographics
NPI:1104037217
Name:RIEBER, DIANA FRANCES (DDS)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:FRANCES
Last Name:RIEBER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3598 YACHT CLUB DR
Mailing Address - Street 2:APT 1202
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-4009
Mailing Address - Country:US
Mailing Address - Phone:917-566-4965
Mailing Address - Fax:
Practice Address - Street 1:6880 TAFT ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-5602
Practice Address - Country:US
Practice Address - Phone:954-987-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052825122300000X
FLDN 18610122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02822237Medicaid