Provider Demographics
NPI:1790272227
Name:RIVERA DOI, DANIELLE SAKURA (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:SAKURA
Last Name:RIVERA DOI
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 1:2254 PENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526-1945
Mailing Address - Country:US
Mailing Address - Phone:585-377-1320
Mailing Address - Fax:
Practice Address - Street 1:2254 PENFIELD RD
Practice Address - Street 2:
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-1945
Practice Address - Country:US
Practice Address - Phone:585-377-1320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0616961223G0001X
MADN18579541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice