Provider Demographics
NPI:1790529782
Name:KAPERS, MADISON MARIE (DMD)
Entity type:Individual
Prefix:DR
First Name:MADISON
Middle Name:MARIE
Last Name:KAPERS
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 1:7568 N ANDERSON DR
Mailing Address - Street 2:
Mailing Address - City:WALKERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46574-7322
Mailing Address - Country:US
Mailing Address - Phone:219-765-1051
Mailing Address - Fax:
Practice Address - Street 1:5408 N JOHNSON RD
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-9376
Practice Address - Country:US
Practice Address - Phone:219-327-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12014465A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice