Active NPI
Carlos Valenzuela, DMD
- Pediatric Dentistry
- Boston, MA
National Provider Identifier
1336524552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DL12654
- Practice address
- 100 E Newton St
Boston, MA 02118-2308 - Phone
- (617) 638-4683
- Fax
- (617) 638-5033
- NPI assigned
- Jul 29, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DL12654 | MA | Primary |
Addresses
Primary practice location
100 E Newton St
Boston, MA 02118-2308
Mailing address
100 E Newton St
Boston, MA 02118-2308
Phone (617) 638-4683
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
| License | State | Type | Specialty |
|---|---|---|---|
| DL12654 | MA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peds Smiles Group LLC | Pediatric Dentistry | Current | 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.
-
- Pediatric Dentistry
- Gilbert, AZ
- NPI 1225715386
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438128000000",
"number": "1336524552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 E NEWTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182308",
"telephone_number": "617-638-4683",
"fax_number": "617-638-5033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E NEWTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182308",
"telephone_number": "617-638-4683",
"fax_number": "617-638-5033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALENZUELA",
"first_name": "CARLOS",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-29",
"last_updated": "2015-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MA",
"license": "DL12654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.