Provider Demographics
NPI:1467533968
Name:HARBIN, JANICE DENISE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:DENISE
Last Name:HARBIN
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 1:82 HOLLAND ST
Mailing Address - Street 2:ALJHC
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14605-2131
Mailing Address - Country:US
Mailing Address - Phone:585-423-2878
Mailing Address - Fax:
Practice Address - Street 1:82 HOLLAND ST
Practice Address - Street 2:ALJHC
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14605-2131
Practice Address - Country:US
Practice Address - Phone:585-423-5800
Practice Address - Fax:585-423-2890
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901012312122300000X
NY056037-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4542196Medicaid