Individual ProviderValencia Tatania LuckmanDentistDental ProvidersPractice Address3737 Moraga Ave, B-206, San Diego, CA 92117-5492(858) 273-0700PECOS EnrollmentBased on the most recent information from CMS, provider Valencia Tatania Luckman does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1275888257Provider TypeIndividualFull NameLuckman, Valencia TataniaCredentialD.O.GenderFemaleSole ProprietorYesEnumeration Date7/17/2012Last Updated7/17/2012Contact InformationPractice LocationPractice Address3737 Moraga Ave, B-206, San Diego, CA 92117-5492Phone(858) 273-0700Fax(858) 273-8679Mailing LocationMailing Address3737 Moraga Ave, B-206, San Diego, CA 92117-5492Phone(858) 273-0700Fax(858) 273-8679Provider TaxonomiesCodeDescriptionLicenseCode122300000XPrimaryDescriptionDentistDental ProvidersLicense43462California