Provider Demographics
NPI:1326236589
Name:WU, JANICE N (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:N
Last Name:WU
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 1:35 E 35TH ST
Mailing Address - Street 2:APT 9E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3823
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:182 FERRY ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-2102
Practice Address - Country:US
Practice Address - Phone:973-589-5759
Practice Address - Fax:973-465-4558
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02356300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist