=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225709728
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DR. VALENTINA SERRANO HILL
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/23/2021
-----------------------------------------------------
Last Update Date | 09/23/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4120 QUEST DR
-----------------------------------------------------
City | EUGENE
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97402-8768
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-688-7278
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3584 NORTH DELTA HIGH WAY 104
-----------------------------------------------------
City | EUGENE
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97408
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-851-5713
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | D11534
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------