Provider Demographics
NPI:1467886259
Name:WELDON, JANETTE LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANETTE
Middle Name:LYNN
Last Name:WELDON
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 1:11650 US HIGHWAY 380 STE 100
Mailing Address - Street 2:
Mailing Address - City:CROSSROADS
Mailing Address - State:TX
Mailing Address - Zip Code:76227-8329
Mailing Address - Country:US
Mailing Address - Phone:940-205-4293
Mailing Address - Fax:
Practice Address - Street 1:11650 US HIGHWAY 380 STE 100
Practice Address - Street 2:
Practice Address - City:CROSSROADS
Practice Address - State:TX
Practice Address - Zip Code:76227-8329
Practice Address - Country:US
Practice Address - Phone:940-205-4293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2019-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002020441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice