Healthcare Provider Details

I. General information

NPI: 1114941614
Provider Name (Legal Business Name): MARILYN PATRICIA RILEY DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL RD CALLER BOX C-268
CHEROKEE NC
28719
US

IV. Provider business mailing address

3909 N ANDREWS AVE
OAKLAND PARK FL
33309-5239
US

V. Phone/Fax

Practice location:
  • Phone: 828-497-9163
  • Fax: 828-497-9163
Mailing address:
  • Phone: 954-561-6675
  • Fax: 954-630-2017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN17611
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN7611
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: