Provider Demographics
NPI:1487928214
Name:VALERIO, WILMA PELAEZ (DDS)
Entity type:Individual
Prefix:
First Name:WILMA
Middle Name:PELAEZ
Last Name:VALERIO
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 1:912 SPARROW CT
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-2225
Mailing Address - Country:US
Mailing Address - Phone:808-384-0578
Mailing Address - Fax:808-384-0578
Practice Address - Street 1:4847 LONE TREE WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8611
Practice Address - Country:US
Practice Address - Phone:925-755-4040
Practice Address - Fax:925-755-4041
Is Sole Proprietor?:No
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA608561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice