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NPI Code Detail

MEDICARE: DR. ALEX CHRISTOPHER RIVERA DDS

MEDICARE: DR. ALEX CHRISTOPHER RIVERA DDS
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
11223G0001XGeneral Practice Dentistry110333CA

General Provider Information

NPI Number : 1871285395
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALEX CHRISTOPHER RIVERA DDS
Provider Business Mailing Address
First Line : 33748 VALLE RD
Second Line :
City : SAN JUAN CAPISTRANO
State : CA
Zip : 92675-4816
Country : US
Telephone Number : 562-416-1359
Fax Number :
Provider Business Practice Location Address
First Line : 1711 ATLANTIC AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90813-2018
Country : US
Telephone Number : 562-591-4028
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2023
Last Update Date : 07/19/2024

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