Provider Demographics
NPI:1255567244
Name:CHAW, JANICE K (DMD)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:K
Last Name:CHAW
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 HUNTINGDON CHASE
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30350-4962
Mailing Address - Country:US
Mailing Address - Phone:510-375-2312
Mailing Address - Fax:
Practice Address - Street 1:2108 HUNTINGDON CHASE
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30350-4962
Practice Address - Country:US
Practice Address - Phone:510-375-2312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0375081223G0001X
GADN0143801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice