Provider Demographics
NPI:1447307012
Name:VALDEZ, DIANE O (DDS)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:O
Last Name:VALDEZ
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 1:31515 RANCHO PUEBLO RD STE 204
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-4837
Mailing Address - Country:US
Mailing Address - Phone:951-302-3322
Mailing Address - Fax:951-302-3325
Practice Address - Street 1:31515 RANCHO PUEBLO RD STE 204
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-4837
Practice Address - Country:US
Practice Address - Phone:951-302-3322
Practice Address - Fax:951-302-3325
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA314111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice