Provider Demographics
NPI:1376950527
Name:VALERIA M. VALDEZ, DMD, INC.
Entity Type:Organization
Organization Name:VALERIA M. VALDEZ, DMD, INC.
Other - Org Name:DR. VALDEZ FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VALERIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:323-953-8762
Mailing Address - Street 1:1860 GLENDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-1762
Mailing Address - Country:US
Mailing Address - Phone:323-953-8762
Mailing Address - Fax:323-953-1874
Practice Address - Street 1:1860 GLENDALE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-1762
Practice Address - Country:US
Practice Address - Phone:323-953-8762
Practice Address - Fax:323-953-1874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56963261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental