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General NPI Number Information
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NPI Number | 1164334884
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Entity Type | Organization
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Legal Business Name | VIVIENE VALDEZ DENTAL CORPORATION
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Dates
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Enumeration Date | 09/18/2026
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Last Update Date | 09/18/2026
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Provider Practice Location Address
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Address Line | 414 N CAMDEN DR STE 675
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4518
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Country | US
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Telephone | 916-702-1213
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Fax |
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Provider Business Mailing Address
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Address Line | 3075 BEACON BLVD
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City | WEST SACRAMENTO
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State | CA
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Zip | 95691-3462
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIR OF PROCESS DEV
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Name | AYREN ENGELHARDT
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Credential |
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Telephone | 916-702-1213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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