Provider Demographics
NPI:1336245992
Name:ANCHETA-CARROLL, JANEL SUPNET (DMD)
Entity Type:Individual
Prefix:DR
First Name:JANEL
Middle Name:SUPNET
Last Name:ANCHETA-CARROLL
Suffix:
Gender:F
Credentials:DMD
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Mailing Address - Street 1:98-1247 KAAHUMANU ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-5311
Mailing Address - Country:US
Mailing Address - Phone:808-487-1000
Mailing Address - Fax:808-487-1004
Practice Address - Street 1:98-1247 KAAHUMANU ST STE 205
Practice Address - Street 2:ANCHETA PEDIATRIC DENTAL LLC
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-5310
Practice Address - Country:US
Practice Address - Phone:808-487-1000
Practice Address - Fax:808-487-1004
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2017-01-10
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Provider Licenses
StateLicense IDTaxonomies
HIDT-20791223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI574857Medicaid