Provider Demographics
NPI:1922840156
Name:VALDES RAMIREZ, LAYRA C (DMD)
Entity type:Individual
Prefix:
First Name:LAYRA
Middle Name:C
Last Name:VALDES RAMIREZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633D DENTAL SQUADRON 77 NEALY AVENUE LANGLEY AFB, VA
Mailing Address - Street 2:
Mailing Address - City:DPO
Mailing Address - State:AA
Mailing Address - Zip Code:23665
Mailing Address - Country:US
Mailing Address - Phone:757-764-6824
Mailing Address - Fax:
Practice Address - Street 1:77 NEALY AVENUE
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:AA
Practice Address - Zip Code:23665
Practice Address - Country:US
Practice Address - Phone:757-764-6824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14025106-9926122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist