Provider Demographics
NPI:1720139678
Name:LAU, JANICE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:
Last Name:LAU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 SCHERMERHORN ST
Mailing Address - Street 2:APT 10F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5039
Mailing Address - Country:US
Mailing Address - Phone:917-671-7878
Mailing Address - Fax:
Practice Address - Street 1:148 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5599
Practice Address - Country:US
Practice Address - Phone:718-875-5437
Practice Address - Fax:718-875-5450
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0492991223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry