MEDICARE: MRS. VIVECA ARIA RITCHIE RDH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	9927	SC

General Provider Information

NPI Number	:	1285379966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VIVECA ARIA RITCHIE RDH

Provider Business Mailing Address
First Line	:	7217 RED MAN DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79934-3436
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2954 CARRINGTON ROAD
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79916
Country	:	US
Telephone Number	:	915-742-2685
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2022
Last Update Date	:	04/28/2022

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