Provider Demographics
NPI:1144535873
Name:VALDEZ, ESTELA (RDHAP)
Entity type:Individual
Prefix:MS
First Name:ESTELA
Middle Name:
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 REGULO PL
Mailing Address - Street 2:1021
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-7755
Mailing Address - Country:US
Mailing Address - Phone:619-997-2396
Mailing Address - Fax:
Practice Address - Street 1:855 REGULO PL
Practice Address - Street 2:1021
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-7755
Practice Address - Country:US
Practice Address - Phone:619-997-2396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA311124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist