Provider Demographics
NPI:1831703800
Name:VALVERDE INGERSOLL, YESSENIA (DMD)
Entity type:Individual
Prefix:DR
First Name:YESSENIA
Middle Name:
Last Name:VALVERDE INGERSOLL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:YESSENIA
Other - Middle Name:
Other - Last Name:VALVERDE GUEVARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:7011 LINDA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-6307
Mailing Address - Country:US
Mailing Address - Phone:858-810-8729
Mailing Address - Fax:
Practice Address - Street 1:7011 LINDA VISTA RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-6307
Practice Address - Country:US
Practice Address - Phone:858-810-8729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-07
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1051811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice