Provider Demographics
NPI:1912013905
Name:RIVERA, DANIEL ARTURO (DDS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ARTURO
Last Name:RIVERA
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 1:1841 N ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-1212
Mailing Address - Country:US
Mailing Address - Phone:909-214-6069
Mailing Address - Fax:
Practice Address - Street 1:450 W SAN JOSE AVE
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-5404
Practice Address - Country:US
Practice Address - Phone:909-626-1292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54567122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist