Provider Demographics
NPI:1548606874
Name:VELASQUEZ-PIERCE, XIMENA (DDS)
Entity Type:Individual
Prefix:
First Name:XIMENA
Middle Name:
Last Name:VELASQUEZ-PIERCE
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 1:1872 S TAMIAMI TRL STE E
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-3129
Mailing Address - Country:US
Mailing Address - Phone:941-497-4997
Mailing Address - Fax:941-408-9665
Practice Address - Street 1:1872 S TAMIAMI TRL STE E
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-3129
Practice Address - Country:US
Practice Address - Phone:941-497-4997
Practice Address - Fax:941-408-9665
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN216071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice