Active NPI
Douglas V. Janis, D.D.S.
- Pediatric Dentistry
- St Charles, IL
National Provider Identifier
1861666331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 021001396
- Practice address
- 40W320 Lafox Rd Ste a
St Charles, IL 60175-6545 - Phone
- (630) 232-6661
- NPI assigned
- Apr 16, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 021001396 | IL | Primary |
Addresses
Primary practice location
40W320 Lafox Rd Ste a
St Charles, IL 60175-6545
Mailing address
1705 South St
Geneva, IL 60134-2583
Phone (630) 232-6661
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021001396 | IL | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537228800000",
"number": "1861666331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1705 SOUTH ST",
"city": "GENEVA",
"state": "IL",
"postal_code": "601342583",
"telephone_number": "630-232-6661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40W320 LAFOX RD STE A",
"city": "ST CHARLES",
"state": "IL",
"postal_code": "601756545",
"telephone_number": "630-232-6661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANIS",
"first_name": "DOUGLAS",
"middle_name": "V.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-16",
"last_updated": "2018-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IL",
"license": "021001396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Charles, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.