Provider Demographics
NPI:1235685124
Name:COMFORT, JANELLE PHAM (DMD)
Entity Type:Individual
Prefix:DR
First Name:JANELLE
Middle Name:PHAM
Last Name:COMFORT
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 1:1200 N TUSTIN AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3535
Mailing Address - Country:US
Mailing Address - Phone:714-835-2215
Mailing Address - Fax:
Practice Address - Street 1:1200 N TUSTIN AVE STE 102
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3535
Practice Address - Country:US
Practice Address - Phone:714-835-2215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1036211223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health