Alejandro Josue Valladares, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DL12522 Issued in MA

Practice address

326 Nichols Rd
Fitchburg, MA 01420-1914

Phone

(978) 878-8100

Fax

(978) 878-8326

NPI assigned

Jul 20, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 11, 2023 through Dec 11, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Wisdom Teeth and Beyond Oral Surgery

  • Oral and Maxillofacial Surgery Clinic/Center
  • Hainesville, IL
  • NPI 1891641148
  NPD Authorized official
• Erickson Oral & Maxillofacial Surgery, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Carol Stream, IL
  • NPI 1215794060
  NPD (past)

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438732800000",
    "number": "1891995593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 NICHOLS RD",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014201914",
            "telephone_number": "978-878-8100",
            "fax_number": "978-878-8326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 NICHOLS RD",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014201914",
            "telephone_number": "978-878-8100",
            "fax_number": "978-878-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLADARES",
        "first_name": "ALEJANDRO",
        "middle_name": "JOSUE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-20",
        "last_updated": "2015-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "DL12522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Urgent Care Centers of Central Massachusetts, LLC
• Kelly M Vaillancourt
• Heather Valdez
• Kisha Vale, BCBA
• Paul Francis Valente, D.C.
• Valley Stream Operator LLC
• Meghan M Vanderhamm, B.S. LSWA
• Alisha A Vanhillo, MA
• Josmaris Vargas Santiago
• Joanne Vautour

• Oral and Maxillofacial Surgery (Dentist) in Fitchburg, MA
• Providers in Fitchburg, MA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.