Provider Demographics
NPI:1396824983
Name:WEAVER, JANET LEIGH (DDS)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LEIGH
Last Name:WEAVER
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 1:10700 BURBANK BLVD
Mailing Address - Street 2:#3
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-2513
Mailing Address - Country:US
Mailing Address - Phone:818-769-2562
Mailing Address - Fax:
Practice Address - Street 1:10700 BURBANK BLVD
Practice Address - Street 2:#3
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-2513
Practice Address - Country:US
Practice Address - Phone:818-769-2562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA314201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice