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NPI Code Detail

MEDICARE: DR. JAIME A VALENCIA DMD

MEDICARE: DR. JAIME A VALENCIA DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDN122562GA
21223G0001XGeneral Practice DentistryDN24446FL
31223X0400XOrthodontics and Dentofacial Orthopedics DentistryDN24446FL
41223X0400XOrthodontics and Dentofacial Orthopedics DentistryDN122562GA

General Provider Information

NPI Number : 1649824475
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAIME A VALENCIA DMD
Provider Business Mailing Address
First Line : 2575 GLADES CIR STE 2
Second Line :
City : WESTON
State : FL
Zip : 33327-2254
Country : US
Telephone Number : 954-384-9908
Fax Number :
Provider Business Practice Location Address
First Line : 1536 EISENHOWER PKWY
Second Line :
City : MACON
State : GA
Zip : 31206-3130
Country : US
Telephone Number : 478-781-4333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2019
Last Update Date : 11/10/2023

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