Provider Demographics
NPI:1326131194
Name:VALENCIA, LUZ-ELENA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LUZ-ELENA
Middle Name:
Last Name:VALENCIA
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 1:625 N MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-4086
Mailing Address - Country:US
Mailing Address - Phone:317-865-1010
Mailing Address - Fax:317-865-7070
Practice Address - Street 1:625 N MADISON AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-4086
Practice Address - Country:US
Practice Address - Phone:317-865-1010
Practice Address - Fax:317-865-7070
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120095881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice