Provider Demographics
NPI:1124581897
Name:VALDES PEREZ, GIELEN (DDS)
Entity type:Individual
Prefix:DR
First Name:GIELEN
Middle Name:
Last Name:VALDES PEREZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11014 SW 119TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-3952
Mailing Address - Country:US
Mailing Address - Phone:786-340-5246
Mailing Address - Fax:
Practice Address - Street 1:12700 SW 119TH ST STE 117
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4502
Practice Address - Country:US
Practice Address - Phone:786-340-5246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR00000001223G0001X
FLDN26330122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice