Provider Demographics
NPI:1194897025
Name:JANKOWSKI, STANLEY A (DDS)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:A
Last Name:JANKOWSKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16000 PEARL RD STE 10
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-6084
Mailing Address - Country:US
Mailing Address - Phone:440-238-4456
Mailing Address - Fax:
Practice Address - Street 1:16000 PEARL RD STE 10
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-6084
Practice Address - Country:US
Practice Address - Phone:440-238-4456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH143011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice