Provider Demographics
NPI:1356993380
Name:DOMINGOES, VALERIE MONCAYO (DMD)
Entity type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:MONCAYO
Last Name:DOMINGOES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:MONCAYO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1122 E SR 434 STE 1020
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-2723
Mailing Address - Country:US
Mailing Address - Phone:407-327-9566
Mailing Address - Fax:
Practice Address - Street 1:1122 E SR 434 STE 1020
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-2723
Practice Address - Country:US
Practice Address - Phone:407-327-9566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-10
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN243601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty