Provider Demographics
NPI:1932335320
Name:VALDEZ, VIVIENE L (DDS)
Entity type:Individual
Prefix:DR
First Name:VIVIENE
Middle Name:L
Last Name:VALDEZ
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 1:675 CONTRA COSTA BLVD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-1514
Mailing Address - Country:US
Mailing Address - Phone:510-689-5800
Mailing Address - Fax:
Practice Address - Street 1:675 CONTRA COSTA BLVD
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-1514
Practice Address - Country:US
Practice Address - Phone:510-689-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-31
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054107-1122300000X
CA592711223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist