Provider Demographics
NPI:1295428431
Name:RIVAS, DIEGO JAVIER (DDS)
Entity type:Individual
Prefix:DR
First Name:DIEGO
Middle Name:JAVIER
Last Name:RIVAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 S DAIRY ASHFORD RD STE 530
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-5729
Mailing Address - Country:US
Mailing Address - Phone:713-376-4330
Mailing Address - Fax:
Practice Address - Street 1:2000 S DAIRY ASHFORD RD STE 530
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-5729
Practice Address - Country:US
Practice Address - Phone:281-597-0404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-01
Last Update Date:2025-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX418631223P0221X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program