Provider Demographics
NPI:1750792057
Name:VALENTA, DAVID ANDREW (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ANDREW
Last Name:VALENTA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 DOMINION WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-1481
Mailing Address - Country:US
Mailing Address - Phone:719-388-8700
Mailing Address - Fax:
Practice Address - Street 1:1975 DOMINION WAY STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1481
Practice Address - Country:US
Practice Address - Phone:719-388-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-08
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2030831223G0001X, 122300000X
NC99801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Yes1223G0001XDental ProvidersDentistGeneral Practice