Provider Demographics
NPI:1689337628
Name:JANU, UPASNA
Entity Type:Individual
Prefix:DR
First Name:UPASNA
Middle Name:
Last Name:JANU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 INDIANAPOLIS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-4204
Mailing Address - Country:US
Mailing Address - Phone:219-864-1133
Mailing Address - Fax:
Practice Address - Street 1:322 INDIANAPOLIS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-4204
Practice Address - Country:US
Practice Address - Phone:219-864-1133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-18
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12013782A1223S0112X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery