Provider Demographics
NPI:1164553681
Name:AKINS, VALERIE TANYA (RDH)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:TANYA
Last Name:AKINS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 WEST ST
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-1531
Mailing Address - Country:US
Mailing Address - Phone:617-413-2330
Mailing Address - Fax:
Practice Address - Street 1:1125 TREMONT ST
Practice Address - Street 2:
Practice Address - City:ROXBURY CROSSING
Practice Address - State:MA
Practice Address - Zip Code:02120-2178
Practice Address - Country:US
Practice Address - Phone:617-427-1000
Practice Address - Fax:617-989-3247
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6456124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist