Healthcare Provider Details

I. General information

NPI: 1427800374
Provider Name (Legal Business Name): MELISA WHITE VALENCIA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2024
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 LASALLE RD SUITE 500
TOWSON MD
21286
US

IV. Provider business mailing address

10012 MORNINGSIDE CT
FAIRFAX VA
22030-2021
US

V. Phone/Fax

Practice location:
  • Phone: 443-846-0130
  • Fax:
Mailing address:
  • Phone: 202-770-6866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number18858
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: