Provider Demographics
NPI:1932349776
Name:JANKE, ANGELA M (RHD)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:M
Last Name:JANKE
Suffix:
Gender:F
Credentials:RHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 JACKIE RD SE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-6618
Mailing Address - Country:US
Mailing Address - Phone:505-264-9226
Mailing Address - Fax:
Practice Address - Street 1:1316 JACKIE RD SE
Practice Address - Street 2:SUITE 300
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-6618
Practice Address - Country:US
Practice Address - Phone:505-264-9226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDH2186124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist