Provider Demographics
NPI:1043424526
Name:JANOSI-FAIR, KATALIN C
Entity Type:Individual
Prefix:DR
First Name:KATALIN
Middle Name:C
Last Name:JANOSI-FAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31105 RANCHO VIEJO RD STE C2
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-1717
Mailing Address - Country:US
Mailing Address - Phone:949-218-3607
Mailing Address - Fax:949-218-3609
Practice Address - Street 1:31105 RANCHO VIEJO RD STE C2
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-1717
Practice Address - Country:US
Practice Address - Phone:949-218-3607
Practice Address - Fax:949-218-3609
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45881122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist