Provider Demographics
NPI:1699892273
Name:JANASH, DAVID (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:JANASH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12510 QUEENS BLVD APT 1403
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-1508
Mailing Address - Country:US
Mailing Address - Phone:212-355-2000
Mailing Address - Fax:866-897-8738
Practice Address - Street 1:30 CENTRAL PARK S
Practice Address - Street 2:SUITE 2C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1628
Practice Address - Country:US
Practice Address - Phone:212-355-4006
Practice Address - Fax:866-897-8738
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0516101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice