Provider Demographics
NPI:1124187620
Name:VOSS, JANA LYNNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANA
Middle Name:LYNNE
Last Name:VOSS
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 1:6539 LANGER LN
Mailing Address - Street 2:
Mailing Address - City:LINO LAKES
Mailing Address - State:MN
Mailing Address - Zip Code:55038-7737
Mailing Address - Country:US
Mailing Address - Phone:651-762-2884
Mailing Address - Fax:
Practice Address - Street 1:1600 SAINT JOHNS BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1183
Practice Address - Country:US
Practice Address - Phone:651-770-7585
Practice Address - Fax:651-770-6021
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND113541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN94943400Medicaid