Provider Demographics
NPI:1225990138
Name:ALVARO VALENCIA BAEZ DDS DENTAL CORPORATION
Entity type:Organization
Organization Name:ALVARO VALENCIA BAEZ DDS DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENCIA BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-467-8050
Mailing Address - Street 1:1001 E VISTA WAY STE 2
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-4604
Mailing Address - Country:US
Mailing Address - Phone:619-467-8050
Mailing Address - Fax:
Practice Address - Street 1:1001 E VISTA WAY STE 2
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-4604
Practice Address - Country:US
Practice Address - Phone:619-467-8050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-29
Last Update Date:2025-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty