Provider Demographics
NPI:1184854366
Name:SANDLER, JANICE DEARBORN (RDH)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:DEARBORN
Last Name:SANDLER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:MISS
Other - First Name:JANICE
Other - Middle Name:THERESE
Other - Last Name:DEARBORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:10803 W MONTE VISTA RD
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-5408
Mailing Address - Country:US
Mailing Address - Phone:602-309-2838
Mailing Address - Fax:
Practice Address - Street 1:4138 W NORTHERN AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-5765
Practice Address - Country:US
Practice Address - Phone:623-866-5482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5621124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist