Provider Demographics
NPI:1932961232
Name:JANET PEZOLD D.D.S., APC
Entity Type:Organization
Organization Name:JANET PEZOLD D.D.S., APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:PEZOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-755-9637
Mailing Address - Street 1:613 RHINE LN
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-3135
Mailing Address - Country:US
Mailing Address - Phone:626-755-9637
Mailing Address - Fax:
Practice Address - Street 1:17122 BEACH BLVD STE 202
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-5992
Practice Address - Country:US
Practice Address - Phone:714-847-9900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental