Provider Demographics
NPI:1326205360
Name:VALENTINO, VINCENT J (DDS)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:J
Last Name:VALENTINO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 BAY RIDGE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-2702
Mailing Address - Country:US
Mailing Address - Phone:718-439-7618
Mailing Address - Fax:718-759-1668
Practice Address - Street 1:472 BAY RIDGE PARKWAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-2702
Practice Address - Country:US
Practice Address - Phone:718-439-7618
Practice Address - Fax:718-759-1668
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31363122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist