=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568201101
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EDUARDO JOSE RIVERA-CASTILLO DMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/22/2024
-----------------------------------------------------
Last Update Date | 02/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CARR 152 KM 7.6 BO QUEBRADILLAS SEC LOS LOPEZ
-----------------------------------------------------
City | BARRANQUITAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00794-9301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-237-5980
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | CARR 152 KM 7.6 BO QUEBRADILLAS SEC LOS LOPEZ
-----------------------------------------------------
City | BARRANQUITAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00794-9301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 3556
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------