Provider Demographics
NPI:1104011584
Name:VALUSEK, JAMES KEVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KEVIN
Last Name:VALUSEK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 W BLUEMOUND RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53213-4145
Mailing Address - Country:US
Mailing Address - Phone:414-771-5600
Mailing Address - Fax:414-476-9988
Practice Address - Street 1:6200 W BLUEMOUND RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53213-4145
Practice Address - Country:US
Practice Address - Phone:414-771-5600
Practice Address - Fax:414-476-9988
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3737122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI3737OtherSTATE LICENSE