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General NPI Number Information
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NPI Number | 1730594896
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Entity Type | Organization
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Legal Business Name | JAIME RIVERA ORTHODONTICS, P.C.
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Dates
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Enumeration Date | 06/27/2014
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 6901 HELEN OF TROY STE D1
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City | EL PASO
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State | TX
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Zip | 79911-3130
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Country | US
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Telephone | 915-585-7550
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Fax | 915-585-7552
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Provider Business Mailing Address
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Address Line | 6901 HELEN OF TROY STE D1
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City | EL PASO
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State | TX
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Zip | 79911-3130
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Country | US
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Telephone | 915-585-7550
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Fax | 915-585-7552
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Authorized Official
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Title or Position | OWNER/ORTHODONTIST
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Name | DR. JAIME RIVERA
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Credential | DMD
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Telephone | 915-585-7550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 22009
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License Number State | TX
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