Provider Demographics
NPI:1568452654
Name:KEANE, JANET (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:
Last Name:KEANE
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 1:55 E MOSHOLU PKWY N
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2625
Mailing Address - Country:US
Mailing Address - Phone:718-652-7370
Mailing Address - Fax:718-882-5650
Practice Address - Street 1:55 E MOSHOLU PKWY N
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2625
Practice Address - Country:US
Practice Address - Phone:718-652-7370
Practice Address - Fax:718-882-5650
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY384201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice