Provider Demographics
NPI:1962616938
Name:VALIENZI, SHARON ANN (RDH)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANN
Last Name:VALIENZI
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:456 AVENIDA DE DIAMANTE
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-1937
Mailing Address - Country:US
Mailing Address - Phone:805-489-8444
Mailing Address - Fax:
Practice Address - Street 1:1558 W GRAND AVE
Practice Address - Street 2:
Practice Address - City:GROVER BEACH
Practice Address - State:CA
Practice Address - Zip Code:93433-2236
Practice Address - Country:US
Practice Address - Phone:805-489-8444
Practice Address - Fax:805-489-4783
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9414124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist