Provider Demographics
NPI:1427261650
Name:VALENCIA ENDODONTIC ASSOCIATES, LLC
Entity type:Organization
Organization Name:VALENCIA ENDODONTIC ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:REED
Authorized Official - Last Name:WOLLARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:816-561-9666
Mailing Address - Street 1:444 W 47TH ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-1957
Mailing Address - Country:US
Mailing Address - Phone:816-561-9666
Mailing Address - Fax:816-561-8304
Practice Address - Street 1:444 W 47TH ST
Practice Address - Street 2:SUITE 210
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-1957
Practice Address - Country:US
Practice Address - Phone:816-561-9666
Practice Address - Fax:816-561-8304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty