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General NPI Number Information
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NPI Number | 1992679534
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Entity Type | Individual
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Provider Name | CARLOS JAVIER VALENCIA RDH
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Gender | Male
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Dates
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Enumeration Date | 10/04/2025
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 1705 W MAIN ST
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City | MESA
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State | AZ
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Zip | 85201-6920
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Country | US
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Telephone | 480-964-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 3033 N CENTRAL AVE STE 145
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City | PHOENIX
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State | AZ
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Zip | 85012-2808
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Country | US
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Telephone | 623-583-3001
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Fax | 623-974-6721
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 4877
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License Number State | AZ
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