Provider Demographics
NPI:1073998399
Name:JANUSZ, KIMBERLY (DDS)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:JANUSZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-2329
Mailing Address - Country:US
Mailing Address - Phone:412-922-9292
Mailing Address - Fax:812-876-7325
Practice Address - Street 1:2725 CENTER ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-2329
Practice Address - Country:US
Practice Address - Phone:412-922-9292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-28
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012302A122300000X
PADS042052122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist