Provider Demographics
NPI:1508881301
Name:JANETTE MURPHY
Entity Type:Organization
Organization Name:JANETTE MURPHY
Other - Org Name:JANETTE LARSEN DMD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JANETTE
Authorized Official - Middle Name:C
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:619-223-6767
Mailing Address - Street 1:2044 CHATSWORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-2716
Mailing Address - Country:US
Mailing Address - Phone:619-223-6767
Mailing Address - Fax:
Practice Address - Street 1:2044 CHATSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92107-2716
Practice Address - Country:US
Practice Address - Phone:619-223-6767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA394361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty