Healthcare Provider Details

I. General information

NPI: 1366427791
Provider Name (Legal Business Name): ESMAEL R VALDEZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 SAINT MICHAELS DR STE 2
SANTA FE NM
87505-7604
US

IV. Provider business mailing address

2500 7TH ST STE H
LAS VEGAS NM
87701-4947
US

V. Phone/Fax

Practice location:
  • Phone: 505-471-7000
  • Fax: 505-387-9011
Mailing address:
  • Phone: 505-454-8483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDD2351
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: