Healthcare Provider Details

I. General information

NPI: 1679153928
Provider Name (Legal Business Name): ZACHARY VALENTINE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 YANKEE PARK PL
DAYTON OH
45458-1878
US

IV. Provider business mailing address

1516 YANKEE PARK PL
DAYTON OH
45458-1878
US

V. Phone/Fax

Practice location:
  • Phone: 937-438-1115
  • Fax: 937-438-1921
Mailing address:
  • Phone: 937-438-1115
  • Fax: 937-438-1921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.149478
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: