Provider Demographics
NPI:1902628399
Name:SEIULI, LIVA JUNIOR II (BDS)
Entity type:Individual
Prefix:DR
First Name:LIVA
Middle Name:JUNIOR
Last Name:SEIULI
Suffix:II
Gender:M
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5375
Mailing Address - Street 2:
Mailing Address - City:PAGO PAGO
Mailing Address - State:AS
Mailing Address - Zip Code:96799-5375
Mailing Address - Country:US
Mailing Address - Phone:684-256-4015
Mailing Address - Fax:
Practice Address - Street 1:HALECK PROFESSIONAL BUILDING, TAFUNA PAGO PAGO
Practice Address - Street 2:
Practice Address - City:PAGOPAGO
Practice Address - State:AS
Practice Address - Zip Code:96799
Practice Address - Country:US
Practice Address - Phone:684-699-6380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AS5082C1223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty