Provider Demographics
NPI:1336799840
Name:JANSEN BEAN DDS PLLC
Entity Type:Organization
Organization Name:JANSEN BEAN DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRONT DESK
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:FEHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-668-5608
Mailing Address - Street 1:9300 WADE BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-2174
Mailing Address - Country:US
Mailing Address - Phone:972-668-5608
Mailing Address - Fax:972-668-5611
Practice Address - Street 1:9300 WADE BLVD STE 250
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-2174
Practice Address - Country:US
Practice Address - Phone:972-668-5608
Practice Address - Fax:972-668-5611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1639396948OtherGENERAL DENISTRY