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General NPI Number Information
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NPI Number | 1881342582
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Entity Type | Individual
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Provider Name | VIVIANA MARCELA TORRES RIZO DDS
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Gender | Female
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Dates
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Enumeration Date | 03/13/2022
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 3402 PARK AVE
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City | WANTAGH
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State | NY
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Zip | 11793-3702
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Country | US
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Telephone | 516-804-5955
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Fax |
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Provider Business Mailing Address
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Address Line | 4306 45TH ST APT 4B
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City | SUNNYSIDE
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State | NY
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Zip | 11104-2324
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Country | US
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Telephone | 347-679-5367
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 063177
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License Number State | NY
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