| Janisse Dental Inc | |
|
2615 N 4th St Ste 6 Flagstaff AZ 86004-1812 | |
| (928) 774-4761 | |
| Not Available |
| Full Name | Janisse Dental Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2615 N 4th St Ste 6, Flagstaff, Arizona |
| Authorized Official Name and Position | Robert Janisse (OWNER) |
| Authorized Official Contact | 9257744761 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Janisse Dental Inc 2615 N 4th St Ste 6 Flagstaff AZ 86004-1812 Ph: (928) 774-4761 | Janisse Dental Inc 2615 N 4th St Ste 6 Flagstaff AZ 86004-1812 Ph: (928) 774-4761 |
| NPI Number | 1073183893 |
|---|---|
| Provider Enumeration Date | 06/25/2021 |
| Last Update Date | 06/25/2021 |
| Medicare PECOS PAC ID | 7911303359 |
|---|---|
| Medicare Enrollment ID | O20210909002209 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073183893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| 261QS0112X | Clinic/center - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
| Provider Name | Robert C Janisse |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1194834895 PECOS PAC ID: 5496067258 Enrollment ID: I20210909003202 |
Michael Mclaughlin Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 940 N Switzer Canyon Dr Ste 201, Flagstaff, AZ 86001 Phone: 928-779-4568 Fax: 928-773-7971 | |
Gary D Milton Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 710 N Beaver St, Bldg 2 1, Flagstaff, AZ 86001 Phone: 928-774-0131 Fax: 928-226-0560 | |
Flagstaff Endodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1600 W University Ave Ste 103, Flagstaff, AZ 86001 Phone: 928-774-4400 Fax: 928-774-5436 | |
Flagstaff Dental Group, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 W Hunt Ave, Flagstaff, AZ 86001 Phone: 928-774-1481 Fax: 928-214-9388 | |
Debonair Ink Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1415 N Beaver St, Flagstaff, AZ 86001 Phone: 928-774-1170 Fax: 928-774-1171 | |
Tuba City Regional Health Care Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6300 N Highway 89, Flagstaff, AZ 86004 Phone: 928-863-7333 Fax: 928-527-2995 |