Provider Demographics
NPI:1679081244
Name:JOSE L RIVERA-ZAYAS DMD PLLC
Entity Type:Organization
Organization Name:JOSE L RIVERA-ZAYAS DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:RIVERA-ZAYAS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:339-999-3266
Mailing Address - Street 1:5 BEDFORD ST UNIT 1231
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-7083
Mailing Address - Country:US
Mailing Address - Phone:339-999-3266
Mailing Address - Fax:
Practice Address - Street 1:800 BOYLSTON ST STE 200
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02199-8176
Practice Address - Country:US
Practice Address - Phone:978-975-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-17
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18578191223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty