Provider Demographics
NPI:1811068810
Name:JANOFF, ALAN DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:DAVID
Last Name:JANOFF
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 1:1203 SALEM AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-5044
Mailing Address - Country:US
Mailing Address - Phone:937-275-7448
Mailing Address - Fax:937-275-0018
Practice Address - Street 1:1203 SALEM AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-5044
Practice Address - Country:US
Practice Address - Phone:937-275-7448
Practice Address - Fax:937-275-0018
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30013410122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0165511Medicaid