Provider Demographics
NPI:1053703421
Name:ANDREWS, JANET (DDS)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 PORTOLA GREEN CIR
Mailing Address - Street 2:
Mailing Address - City:PORTOLA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94028-7833
Mailing Address - Country:US
Mailing Address - Phone:650-851-5675
Mailing Address - Fax:650-529-0876
Practice Address - Street 1:18 PORTOLA GREEN CIR
Practice Address - Street 2:
Practice Address - City:PORTOLA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94028-7833
Practice Address - Country:US
Practice Address - Phone:650-851-5675
Practice Address - Fax:650-529-0876
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31747122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist