Individual provider Active NPI

Carolina Gutierrez-Valdez, DDS

  • Dentist
  • La Puente, CA
National Provider Identifier
1043794142
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS103168 Issued in CA
Practice address
15454 Gale Ave Ste a
La Puente, CA 91745-1593
Phone
(626) 333-3600
NPI assigned
Sep 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS103168 CA Primary

Addresses

Primary practice location

15454 Gale Ave Ste a
La Puente, CA 91745-1593

Mailing address

15454 Gale Ave Ste a
La Puente, CA 91745-1593
Phone (626) 333-3600

Other practice location 1

4055 E Olympic Blvd Ste 211
Los Angeles, CA 90023-3345
Phone (323) 264-0205

Other practice location 2

8345 Laurel Canyon Blvd
Sun Valley, CA 91352-3809
Phone (818) 351-3582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DDS103168CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Carmen Valdez D.D.S Inc CurrentSince Mar 19, 2023 Accepting new patients
Sahawneh Dental Corporation Dentist PastSince Jan 10, 2021 Accepting new patients

Locations

15454 Gale Ave
Ste A
La Puente, CA 91745
Phone (626) 333-3600

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1043794142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15454 GALE AVE STE A",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917451593",
            "telephone_number": "626-333-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15454 GALE AVE STE A",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917451593",
            "telephone_number": "626-333-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4055 E Olympic Blvd Ste 211",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900233345",
            "country_code": "US",
            "telephone_number": "323-264-0205",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8345 Laurel Canyon Blvd",
            "address_purpose": "LOCATION",
            "city": "Sun Valley",
            "state": "CA",
            "postal_code": "913523809",
            "country_code": "US",
            "telephone_number": "818-351-3582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ-VALDEZ",
        "first_name": "CAROLINA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-24",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS103168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Puente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.