Provider Demographics
NPI:1215373873
Name:VALENTINE, AMBER (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:
Last Name:VALENTINE
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 1:1230 N BROADMOOR ST
Mailing Address - Street 2:SUITE #300
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-3800
Mailing Address - Country:US
Mailing Address - Phone:316-630-0303
Mailing Address - Fax:316-630-0004
Practice Address - Street 1:1230 N BROADMOOR ST
Practice Address - Street 2:SUITE #300
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3800
Practice Address - Country:US
Practice Address - Phone:316-630-0303
Practice Address - Fax:316-630-0004
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60978122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist