Provider Demographics
NPI:1548832306
Name:VILLANUEVA, CLAUDIA SOPHIA (DDS)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:SOPHIA
Last Name:VILLANUEVA
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 1:3200 LA COSTA CIR APT 105
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-6617
Mailing Address - Country:US
Mailing Address - Phone:585-967-9447
Mailing Address - Fax:
Practice Address - Street 1:8951 BONITA BEACH RD SE STE 206
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-4202
Practice Address - Country:US
Practice Address - Phone:239-992-8555
Practice Address - Fax:239-992-8644
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN26164122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist