Valeria Labastida Torres

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN122614 Issued in GA

Practice address

1955 N Cobb Pkwy Ste 110
Kennesaw, GA 30152-4503

Phone

(770) 799-8964

NPI assigned

Oct 27, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654992000000",
    "number": "1467052613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 WAVERLY CV",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300040669",
            "telephone_number": "817-734-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 N COBB PKWY STE 110",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524503",
            "telephone_number": "770-799-8964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 Broadway",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112065317",
            "country_code": "US",
            "telephone_number": "718-963-5765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LABASTIDA TORRES",
        "first_name": "VALERIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2022-06-12",
        "certification_date": "2022-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Maddox Kresge
• Molly Jane Krue
• Meredith Marie Krugh, NP
• Rekha Anjali Kumbla, MD
• Daniel John Kuzio, M.D.
• Labor of Love Total Care, Inc
• Brian Labruzzo
• Kelly Lacy
• Lydia Mischa Lacy, MA.CCC.SLP
• Torie Danielle Ladendorf

• General Practice Dentistry in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2022; 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.