Provider Demographics
NPI:1841055233
Name:JANS DENTAL LLC
Entity type:Organization
Organization Name:JANS DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:JANS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:815-436-1000
Mailing Address - Street 1:24204 W LOCKPORT ST
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-2902
Mailing Address - Country:US
Mailing Address - Phone:815-436-1000
Mailing Address - Fax:
Practice Address - Street 1:24204 W LOCKPORT ST
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-2902
Practice Address - Country:US
Practice Address - Phone:815-436-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental