Healthcare Provider Details

I. General information

NPI: 1720862782
Provider Name (Legal Business Name): VERONICA VELAZQUEZ DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8316 FOOTHILL BLVD
SUNLAND CA
91040-2850
US

IV. Provider business mailing address

PO BOX 51613
SPARKS NV
89435-1613
US

V. Phone/Fax

Practice location:
  • Phone: 818-273-8800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS112931
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: