Provider Demographics
NPI:1932121993
Name:JAUNBERZINS, ANDRIS (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ANDRIS
Middle Name:
Last Name:JAUNBERZINS
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 N MAYFAIR RD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-1409
Mailing Address - Country:US
Mailing Address - Phone:414-258-4882
Mailing Address - Fax:414-258-4855
Practice Address - Street 1:2500 N MAYFAIR RD
Practice Address - Street 2:SUITE 360
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-1409
Practice Address - Country:US
Practice Address - Phone:414-258-4882
Practice Address - Fax:414-258-4855
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI54781223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics