Individual provider Active NPI

Odalys Valenzuela, DDS

  • General Practice Dentistry
  • Hialeah, FL
National Provider Identifier
1063601631
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15755 Issued in FL
Practice address
4355 W 16TH Ave Ste 205a
Hialeah, FL 33012-7668
Phone
(305) 824-9199
Fax
(305) 824-8885
NPI assigned
Oct 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15755 FL Primary

Addresses

Primary practice location

4355 W 16TH Ave Ste 205a
Hialeah, FL 33012-7668

Mailing address

4355 W 16TH Ave Ste 205a
Hialeah, FL 33012-7668
Phone (305) 824-9199

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
15755FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Dental Alliance General Practice PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 1

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": "1192752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1063601631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4355 W 16TH AVE STE 205A",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330127668",
            "telephone_number": "305-824-9199",
            "fax_number": "305-824-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4355 W 16TH AVE STE 205A",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330127668",
            "telephone_number": "305-824-9199",
            "fax_number": "305-824-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENZUELA",
        "first_name": "ODALYS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-19",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "15755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; 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.