Provider Demographics
NPI:1003017005
Name:SEIFERT, VALERIE MARTINSEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:MARTINSEN
Last Name:SEIFERT
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 1:1011 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46350-3506
Mailing Address - Country:US
Mailing Address - Phone:219-362-1101
Mailing Address - Fax:219-325-3550
Practice Address - Street 1:1011 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-3506
Practice Address - Country:US
Practice Address - Phone:219-362-1101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010973A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice