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Individual

DR. JAIME RIVERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D

Contact information

Practice address
7482 PASEO DEL NORTE, EL PASO, TX 79911-3200
(915) 585-7550
(915) 585-7552
Mailing address
7482 PASEO DEL NORTE, EL PASO, TX 79911-3200
(915) 585-7550
(915) 585-7552

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
22009
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
22009
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00142477
DPS
TX
05
213495901
TX
05
213495902
TX
01
22009
TEXAS LICENSE DENTIST
TX
01
DD3905
NEW MEXICO DENTAL LICENSE
NM
Enumeration date
07/05/2006
Last updated
03/20/2025
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