Provider Demographics
NPI:1538329461
Name:JANICE WEINMAN, D.D.S.
Entity Type:Organization
Organization Name:JANICE WEINMAN, D.D.S.
Other - Org Name:SEGUIN SMILES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/SOLE PRO
Authorized Official - Prefix:DR
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:VLASAK
Authorized Official - Last Name:WEINMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:830-372-2949
Mailing Address - Street 1:1460 EASTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-5216
Mailing Address - Country:US
Mailing Address - Phone:830-372-2949
Mailing Address - Fax:830-372-3636
Practice Address - Street 1:1460 EASTWOOD DR
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5216
Practice Address - Country:US
Practice Address - Phone:830-372-2949
Practice Address - Fax:830-372-3636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1208324Medicaid