Wesley D Janssen, DDS

Individual provider Active NPI General Practice Dentistry · Syracuse, NE

NPI 1033213780 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1033213780
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
4745 (NE)
Practice address
557 Mohawk St
Syracuse, NE 68446-0336
Phone
(402) 269-2535
Fax
(402) 269-2535
NPI assigned
Sep 12, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4745 NE Yes

Addresses

Primary practice location

557 Mohawk St
Syracuse, NE 68446-0336

Mailing address

PO Box 336
Syracuse, NE 68446-0336
Phone (402) 269-2535

Other identifiers

IdentifierTypeStateIssuer
05377OtherNEBLUE CROSS
47061931400MedicaidNE

Other providers in Syracuse, NE

All providers in Syracuse, NE · General Practice Dentistry in Nebraska

Sources for this page

Verify at the official NPI Registry.