Provider Demographics
NPI:1083097182
Name:SILLIMAN, JANIELLE (DMD)
Entity Type:Individual
Prefix:
First Name:JANIELLE
Middle Name:
Last Name:SILLIMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1865 HILLVIEW ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-3606
Mailing Address - Country:US
Mailing Address - Phone:941-365-4500
Mailing Address - Fax:941-365-5788
Practice Address - Street 1:1865 HILLVIEW ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3606
Practice Address - Country:US
Practice Address - Phone:941-365-4500
Practice Address - Fax:941-365-5788
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN21170122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist