NPIMap

Organization Active NPI

Viviene Valdez Dental Corporation

  • Pediatric Dentistry
  • Pinole, CA
National Provider Identifier
1114720356
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
VIVIENE VALDEZ DENTAL CORPORATION
Practice address
2762 Pinole Valley Rd
Pinole, CA 94564-1425
Phone
(916) 259-9255
Fax
(916) 384-3844
NPI assigned
Mar 31, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Authorized official

Name
Yekaterina Vusik
Title
Credentialing Assistant
Phone
(916) 259-9255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

2762 Pinole Valley Rd
Pinole, CA 94564-1425

Mailing address

3075 Beacon Blvd
West Sacramento, CA 95691-3462
Phone (916) 259-9255

Other names 1

  • Kali Smiles Kids Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Viviene Valdez Dental Corporation7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2762 Pinole Valley Rd
Pinole, CA 94564
Phone (510) 758-6684

NPI Registry JSON

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

{
    "created_epoch": "1743379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743379200000",
    "number": "1114720356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 BEACON BLVD",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913462",
            "telephone_number": "916-259-9255",
            "fax_number": "916-384-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2762 PINOLE VALLEY RD",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945641425",
            "telephone_number": "916-259-9255",
            "fax_number": "916-384-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVIENE VALDEZ DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A",
        "authorized_official_last_name": "VUSIK",
        "authorized_official_first_name": "YEKATERINA",
        "authorized_official_title_or_position": "CREDENTIALING ASSISTANT",
        "authorized_official_telephone_number": "916-259-9255"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kali Smiles Kids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pinole, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.