Provider Demographics
NPI:1073294211
Name:ORIGEL, JANESSA MARIE
Entity Type:Individual
Prefix:
First Name:JANESSA
Middle Name:MARIE
Last Name:ORIGEL
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:PSC 41 BOX 2218
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09464-0023
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BLDG 944 RAF LAKENHEATH
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:UNITED KINGDOM
Practice Address - Zip Code:IP27 9PN
Practice Address - Country:GB
Practice Address - Phone:314-226-8317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant