Healthcare Provider Details

I. General information

NPI: 1649207259
Provider Name (Legal Business Name): CARMELO MARTINEZ-RIVERA D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 01/11/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BB25 AVE SANTA JUANITA
BAYAMON PR
00956-4633
US

IV. Provider business mailing address

BB-25 SANTA JUANITA AVE.
BAYAMON PR
00956
US

V. Phone/Fax

Practice location:
  • Phone: 787-787-9043
  • Fax: 787-786-5260
Mailing address:
  • Phone: 787-787-9043
  • Fax: 787-786-5260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD0685
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: