Provider Demographics
NPI:1699186148
Name:JANSSEN, GUY HUGH (DDS)
Entity Type:Individual
Prefix:DR
First Name:GUY
Middle Name:HUGH
Last Name:JANSSEN
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 1:1889 ORCHARD CT
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-1094
Mailing Address - Country:US
Mailing Address - Phone:219-322-4857
Mailing Address - Fax:
Practice Address - Street 1:1889 ORCHARD CT
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-1094
Practice Address - Country:US
Practice Address - Phone:219-322-4857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-17
Last Update Date:2014-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12005554A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist