Healthcare Provider Details

I. General information

NPI: 1811852486
Provider Name (Legal Business Name): VALDEZ DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 PIONEER DRIVE
VALDEZ AK
99686-0531
US

IV. Provider business mailing address

PO BOX 531
VALDEZ AK
99686-0531
US

V. Phone/Fax

Practice location:
  • Phone: 907-835-4940
  • Fax: 907-835-2570
Mailing address:
  • Phone: 907-835-4940
  • Fax: 907-835-2570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BENJAMIN EDWARD MELTON
Title or Position: DENTIST
Credential: DDS
Phone: 731-297-7894