Provider Demographics
NPI:1063564136
Name:VALENCIA, SARA (DDS)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:
Last Name:VALENCIA
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 1:1509 CABRILLO AVENUE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-2818
Mailing Address - Country:US
Mailing Address - Phone:310-783-0344
Mailing Address - Fax:310-328-2803
Practice Address - Street 1:1509 CABRILLO AVENUE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-2818
Practice Address - Country:US
Practice Address - Phone:310-783-0344
Practice Address - Fax:310-328-2803
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38969122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist