Provider Demographics
NPI:1073694881
Name:ALAN D JANOFF DDS & DENNIS D BAUM DDS INC
Entity Type:Organization
Organization Name:ALAN D JANOFF DDS & DENNIS D BAUM DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:JANOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:987-275-7448
Mailing Address - Street 1:1203 SALEM AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-5044
Mailing Address - Country:US
Mailing Address - Phone:937-275-7448
Mailing Address - Fax:937-275-0018
Practice Address - Street 1:1203 SALEM AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-5044
Practice Address - Country:US
Practice Address - Phone:937-275-7448
Practice Address - Fax:937-275-0018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0371922Medicaid