Provider Demographics
NPI:1952848673
Name:JANET CENTURY DDS LTD
Entity Type:Organization
Organization Name:JANET CENTURY DDS LTD
Other - Org Name:LAKESIDE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:H
Authorized Official - Last Name:CENTURY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-438-7338
Mailing Address - Street 1:106 S WYNSTONE PARK DR
Mailing Address - Street 2:102
Mailing Address - City:N BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-6961
Mailing Address - Country:US
Mailing Address - Phone:847-438-7338
Mailing Address - Fax:847-327-1579
Practice Address - Street 1:106 S WYNSTONE PARK DR
Practice Address - Street 2:102
Practice Address - City:N BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-6961
Practice Address - Country:US
Practice Address - Phone:847-438-7338
Practice Address - Fax:847-327-1579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019020578122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty