Provider Demographics
NPI:1497590483
Name:VALBUENA, MARIA K (DMD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:K
Last Name:VALBUENA
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 1:12890 OLD MERIDIAN ST APT 123
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-8947
Mailing Address - Country:US
Mailing Address - Phone:317-378-5859
Mailing Address - Fax:
Practice Address - Street 1:10967 ALLISONVILLE RD
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2632
Practice Address - Country:US
Practice Address - Phone:317-572-8626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12014520A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty