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General NPI Number Information
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NPI Number | 1063073914
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Entity Type | Individual
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Provider Name | VICTORIA MARIE DELEON
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Gender | Female
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Dates
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Enumeration Date | 06/21/2019
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 5290 N A W GRIMES BLVD STE 400
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City | ROUND ROCK
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State | TX
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Zip | 78665-3036
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Country | US
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Telephone | 512-394-6255
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Fax |
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Provider Business Mailing Address
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Address Line | 101 N BROOKSIDE DR APT 515
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City | DALLAS
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State | TX
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Zip | 75214-4590
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Country | US
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Telephone | 512-507-1817
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 35296
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 35296
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License Number State | TX
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