Provider Demographics
NPI:1033857164
Name:LEONETT SERRANO, VALENTINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:VALENTINA
Middle Name:
Last Name:LEONETT SERRANO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1865 S RACINE LN
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-9059
Mailing Address - Country:US
Mailing Address - Phone:786-612-5688
Mailing Address - Fax:
Practice Address - Street 1:2072 E SOUTHERN AVE STE A101
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7500
Practice Address - Country:US
Practice Address - Phone:480-491-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0113971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice