Gerson Sanchez Valles, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D-569 Issued in GU

Practice address

414 W Soledad Ave Ste 300
Hagatna, GU 96910-5073

Phone

(671) 472-2489

Fax

(671) 477-9275

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649360702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 W SOLEDAD AVE STE 300",
            "city": "HAGATNA",
            "state": "GU",
            "postal_code": "969105073",
            "telephone_number": "671-472-2489",
            "fax_number": "671-477-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 W SOLEDAD AVE STE 300",
            "city": "HAGATNA",
            "state": "GU",
            "postal_code": "969105073",
            "telephone_number": "671-472-2489",
            "fax_number": "671-477-9275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLES",
        "first_name": "GERSON",
        "middle_name": "SANCHEZ",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "26241",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GU",
            "license": "D-569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.