Individual provider Active NPI

Wilma Pelaez Valerio, DDS

  • General Practice Dentistry
  • Antioch, CA
National Provider Identifier
1487928214
Registry record updated Feb 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
60856 Issued in CA
Practice address
4847 Lone Tree Way
Antioch, CA 94531-8611
Phone
(925) 755-4040
Fax
(925) 755-4041
NPI assigned
Feb 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 60856 CA Primary

Addresses

Primary practice location

4847 Lone Tree Way
Antioch, CA 94531-8611

Mailing address

912 Sparrow CT
Newport News, VA 23608-2225
Phone (808) 384-0578

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
60856CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330041600000",
    "number": "1487928214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 SPARROW CT",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236082225",
            "telephone_number": "808-384-0578",
            "fax_number": "808-384-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4847 LONE TREE WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318611",
            "telephone_number": "925-755-4040",
            "fax_number": "925-755-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALERIO",
        "first_name": "WILMA",
        "middle_name": "PELAEZ",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-24",
        "last_updated": "2012-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "60856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; 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.