Provider Demographics
NPI:1912991563
Name:VALDEZ, VALERIA M (DMD)
Entity type:Individual
Prefix:DR
First Name:VALERIA
Middle Name:M
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 GLENDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-1762
Mailing Address - Country:US
Mailing Address - Phone:323-953-8762
Mailing Address - Fax:323-953-1874
Practice Address - Street 1:1860 GLENDALE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-1762
Practice Address - Country:US
Practice Address - Phone:323-953-8762
Practice Address - Fax:323-953-1874
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56963122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist