Provider Demographics
NPI:1902886476
Name:RIVERA ADAMES, SAMMY (DMD)
Entity Type:Individual
Prefix:DR
First Name:SAMMY
Middle Name:
Last Name:RIVERA ADAMES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1791
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-1791
Mailing Address - Country:US
Mailing Address - Phone:787-734-0000
Mailing Address - Fax:787-734-0000
Practice Address - Street 1:CALLE LOPEZ HORMAZABAL
Practice Address - Street 2:C-15 URB. MADRID
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777
Practice Address - Country:US
Practice Address - Phone:787-734-0000
Practice Address - Fax:787-734-0000
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2320122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist