Provider Demographics
NPI:1326889221
Name:NASSAR, JANELLE MARIE (DMD)
Entity type:Individual
Prefix:DR
First Name:JANELLE
Middle Name:MARIE
Last Name:NASSAR
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 1:355 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PORT REPUBLIC
Mailing Address - State:NJ
Mailing Address - Zip Code:08241-9780
Mailing Address - Country:US
Mailing Address - Phone:609-214-9613
Mailing Address - Fax:
Practice Address - Street 1:1685 CROWN AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6322
Practice Address - Country:US
Practice Address - Phone:717-481-7645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS044661122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist