Provider Demographics
NPI:1437277712
Name:CARDENAS, MARIA ELENA VALERA (DMD)
Entity Type:Individual
Prefix:
First Name:MARIA ELENA
Middle Name:VALERA
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3227 CONATA ST
Mailing Address - Street 2:
Mailing Address - City:DUARTE
Mailing Address - State:CA
Mailing Address - Zip Code:91010-1652
Mailing Address - Country:US
Mailing Address - Phone:626-930-0989
Mailing Address - Fax:
Practice Address - Street 1:15570 GALE AVE
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-1513
Practice Address - Country:US
Practice Address - Phone:626-934-9188
Practice Address - Fax:626-934-9178
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA426391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice