Provider Demographics
NPI:1861710378
Name:REDDEN, VALENTINA (DDS)
Entity type:Individual
Prefix:DR
First Name:VALENTINA
Middle Name:
Last Name:REDDEN
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 1:111 N EUCLID ST
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-4614
Mailing Address - Country:US
Mailing Address - Phone:562-309-1070
Mailing Address - Fax:562-697-5844
Practice Address - Street 1:111 N EUCLID ST
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-4614
Practice Address - Country:US
Practice Address - Phone:562-309-1070
Practice Address - Fax:562-697-5844
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-07
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54766122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist