Provider Demographics
NPI:1821982331
Name:RIVERA-CONCEPCION, ANGELIZ (DDS)
Entity type:Individual
Prefix:DR
First Name:ANGELIZ
Middle Name:
Last Name:RIVERA-CONCEPCION
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6459 BROOKSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-6512
Mailing Address - Country:US
Mailing Address - Phone:919-903-1789
Mailing Address - Fax:
Practice Address - Street 1:103 SUPERIOR DR
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:NC
Practice Address - Zip Code:28390-3193
Practice Address - Country:US
Practice Address - Phone:910-497-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-07
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC142291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice