Richard Valera, DMD
Individual provider Active NPI Dentist · Sunrise, FL
NPI 1366019200 · NPPES record last updated Jun 24, 2024
Key facts
- NPI
- 1366019200
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DN25901 (FL)
- Practice address
- 12651 W Sunrise Blvd Ste 304
Sunrise, FL 33323-0906 - Phone
- (954) 807-2993
- NPI assigned
- Jun 9, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN25901 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Island Dental,PA | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN25901 | FL | Yes |
Addresses
Primary practice location
12651 W Sunrise Blvd Ste 304
Sunrise, FL 33323-0906
Mailing address
940 NW 4TH St
Belle Glade, FL 33430-1908
Phone (561) 261-7911
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | VYNE | Health Information Exchange (HIE) |
Other providers in Sunrise, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.