Individual provider Active NPI

Valeria Kresevic, D.D.S.

  • Dentist
  • Wellington, FL
National Provider Identifier
1164528147
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN29958 Issued in FL
Practice address
3240 Lago de Talavera
Wellington, FL 33467-1068
Phone
(585) 752-2996
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN29958 FL Primary

Addresses

Primary practice location

3240 Lago de Talavera
Wellington, FL 33467-1068

Mailing address

3240 Lago de Talavera
Wellington, FL 33467-1068
Phone (956) 686-8611

Other identifiers 1

IdentifierTypeStateIssuer
209480703MedicaidTX

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
DN29958FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Patrick B. Wilcox D.D.S, Pediatric Dentistry Dentist Past 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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1164528147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 LAGO DE TALAVERA",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334671068",
            "telephone_number": "956-686-8611",
            "fax_number": "956-686-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 LAGO DE TALAVERA",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334671068",
            "telephone_number": "585-752-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRESEVIC",
        "first_name": "VALERIA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN29958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209480703",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; 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.