Provider Demographics
NPI:1578832572
Name:DOAN, JANICE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:
Last Name:DOAN
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 1:5059 EL CAJON BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-3348
Mailing Address - Country:US
Mailing Address - Phone:619-265-2467
Mailing Address - Fax:
Practice Address - Street 1:3780 EL CAJON BLVD
Practice Address - Street 2:UNIT #1
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-1080
Practice Address - Country:US
Practice Address - Phone:619-265-2467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-20
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59190122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist