Provider Demographics
NPI:1902598824
Name:VELOZ DENTISTRY PLLC
Entity type:Organization
Organization Name:VELOZ DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VELOZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:352-460-5165
Mailing Address - Street 1:489 DAGAMA DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34715-8037
Mailing Address - Country:US
Mailing Address - Phone:352-460-5165
Mailing Address - Fax:
Practice Address - Street 1:3214 CITRUS TOWER BLVD
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711
Practice Address - Country:US
Practice Address - Phone:352-460-5165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental