Provider Demographics
NPI:1164410619
Name:RIVERA, HANNIA ADNIL (DMD)
Entity Type:Individual
Prefix:MISS
First Name:HANNIA
Middle Name:ADNIL
Last Name:RIVERA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STREET 4 , S-2 #16, VILLA PARANA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00925
Mailing Address - Country:US
Mailing Address - Phone:787-753-4232
Mailing Address - Fax:787-753-8738
Practice Address - Street 1:GEORGETTI #70
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925
Practice Address - Country:US
Practice Address - Phone:787-667-2251
Practice Address - Fax:787-789-4473
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13691223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist