Provider Demographics
NPI:1790813855
Name:PISHNY, JANICE R (DDS)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:R
Last Name:PISHNY
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 1:10124 W 119TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-1461
Mailing Address - Country:US
Mailing Address - Phone:913-491-6929
Mailing Address - Fax:913-491-0906
Practice Address - Street 1:10124 W 119TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-1461
Practice Address - Country:US
Practice Address - Phone:913-491-6929
Practice Address - Fax:913-491-0906
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice