Provider Demographics
NPI:1285840744
Name:RIVERO, JOY ANGELIQUE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOY
Middle Name:ANGELIQUE
Last Name:RIVERO
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 1:4225 HOYT AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-2351
Mailing Address - Country:US
Mailing Address - Phone:425-252-6666
Mailing Address - Fax:888-456-0249
Practice Address - Street 1:4225 HOYT AVE
Practice Address - Street 2:SUITE B
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2351
Practice Address - Country:US
Practice Address - Phone:425-252-6666
Practice Address - Fax:888-456-0249
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000109231223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics