Provider Demographics
NPI:1700090693
Name:RICHARD D RIVA DDS & GERARD A BEGLEY DMD LLC
Entity Type:Organization
Organization Name:RICHARD D RIVA DDS & GERARD A BEGLEY DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST ORALANDMAXILLOFACIAL SURGEY
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-601-0606
Mailing Address - Street 1:22 HOWARD BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:MOUNT ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07856-1532
Mailing Address - Country:US
Mailing Address - Phone:973-601-0606
Mailing Address - Fax:
Practice Address - Street 1:22 HOWARD BLVD
Practice Address - Street 2:STE 201
Practice Address - City:MOUNT ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07856-1532
Practice Address - Country:US
Practice Address - Phone:973-601-0606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RICHARD D RIVA DDS & GERARD A BEGLEY DMD LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-09
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01029901223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22DI01029900OtherLICENSE
NJ22DI01029900OtherLICENSE
NJ=========OtherEIN