Healthcare Provider Details

I. General information

NPI: 1093604316
Provider Name (Legal Business Name): VALENTINA ROA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14938 PINES BLVD
PEMBROKE PINES FL
33027-1213
US

IV. Provider business mailing address

16888 SW 16TH ST
PEMBROKE PINES FL
33027-1415
US

V. Phone/Fax

Practice location:
  • Phone: 954-433-2099
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30642
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: