Provider Demographics
NPI:1619038825
Name:HOLDEN, JANELLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANELLE
Middle Name:
Last Name:HOLDEN
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 1:451 MANHATTAN BEACH BLVD
Mailing Address - Street 2:SUITE D226
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-5345
Mailing Address - Country:US
Mailing Address - Phone:310-545-5757
Mailing Address - Fax:310-545-2929
Practice Address - Street 1:451 MANHATTAN BEACH BLVD
Practice Address - Street 2:SUITE D226
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-5345
Practice Address - Country:US
Practice Address - Phone:310-545-5757
Practice Address - Fax:310-545-2929
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA416171223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry