Provider Demographics
NPI:1184728644
Name:JANSSEN, RODNEY R (DDS)
Entity type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:R
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 1:2235 MISSION ST SE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-1298
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2235 MISSION ST SE
Practice Address - Street 2:SUITE 250
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-1298
Practice Address - Country:US
Practice Address - Phone:503-371-3220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR54671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice