Provider Demographics
NPI:1336293638
Name:MADKINS, JANIS PIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANIS
Middle Name:PIA
Last Name:MADKINS
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:PO BOX 638
Mailing Address - Street 2:
Mailing Address - City:HAPPY CAMP
Mailing Address - State:CA
Mailing Address - Zip Code:96039-0638
Mailing Address - Country:US
Mailing Address - Phone:530-493-1650
Mailing Address - Fax:
Practice Address - Street 1:64236 2ND AVE
Practice Address - Street 2:
Practice Address - City:HAPPY CAMP
Practice Address - State:CA
Practice Address - Zip Code:96039
Practice Address - Country:US
Practice Address - Phone:530-493-1650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA521671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice