MEDICARE: DR. LLELENYS PAOLA RIVERA RIVERA DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0700X	Prosthodontics	35834	TX
2	1223P0700X	Prosthodontics	3509	PR

General Provider Information

NPI Number	:	1790201838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LLELENYS PAOLA RIVERA RIVERA DMD

Provider Business Mailing Address
First Line	:	PO BOX 417
Second Line	:
City	:	TRUJILLO ALTO
State	:	PR
Zip	:	00977-0417
Country	:	US
Telephone Number	:	787-340-8691
Fax Number	:

Provider Business Practice Location Address
First Line	:	1738 CALLE AMARILLO
Second Line	:	EDF. SUMMIT, STE. 104
City	:	SAN JUAN
State	:	PR
Zip	:	00926-3072
Country	:	US
Telephone Number	:	787-340-8691
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2017
Last Update Date	:	09/16/2025

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Directions to “ DR. LLELENYS PAOLA RIVERA RIVERA DMD” Practice Location

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