Provider Demographics
NPI:1629123914
Name:JANOV, BARRY ALLAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:ALLAN
Last Name:JANOV
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2454 E DEMPSTER ST
Mailing Address - Street 2:SUITE 416
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-5315
Mailing Address - Country:US
Mailing Address - Phone:847-827-9100
Mailing Address - Fax:
Practice Address - Street 1:2454 E DEMPSTER ST
Practice Address - Street 2:SUITE 416
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-5315
Practice Address - Country:US
Practice Address - Phone:847-827-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL01911495122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist