Provider Demographics
NPI:1881885226
Name:VALERY SWEEENY D.D.S., A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:VALERY SWEEENY D.D.S., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VALERY
Authorized Official - Middle Name:SANDRA
Authorized Official - Last Name:SWEENY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-669-0339
Mailing Address - Street 1:3706 W SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-1528
Mailing Address - Country:US
Mailing Address - Phone:323-669-0339
Mailing Address - Fax:
Practice Address - Street 1:3706 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-1528
Practice Address - Country:US
Practice Address - Phone:323-669-0339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42616261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental