Provider Demographics
NPI:1760777593
Name:MUKANGA, VALERIE OSAKO (DDS)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:OSAKO
Last Name:MUKANGA
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 1:913 SAGE MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:GLENN HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:75154-8440
Mailing Address - Country:US
Mailing Address - Phone:214-791-1996
Mailing Address - Fax:866-604-9227
Practice Address - Street 1:3220 GUS THOMASSON RD
Practice Address - Street 2:100
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4057
Practice Address - Country:US
Practice Address - Phone:214-791-1996
Practice Address - Fax:866-604-9227
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27983122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist