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JEDIDIAH L JANISSE DMD AND ASSOCIATES LTD NPI 1083850374


NPI Information

NPI: 1083850374
Provider Name: JEDIDIAH L JANISSE DMD AND ASSOCIATES, LTD
Classification: Clinic/Center - 261QS0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
217 MAXHAM MEADOW WAY # 10
SUITE 4C
WOODSTOCK, VT
ZIP 05091
Phone: (802) 457-1903
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JEDIDIAH L JANISSE DMD AND ASSOCIATES, LTD is an oral and maxillofacial surgery clinic center in Woodstock, VT. The provider is an oral and maxillofacial surgery clinic or center specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. JEDIDIAH L JANISSE DMD AND ASSOCIATES, LTD NPI is 1083850374. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

217 MAXHAM MEADOW WAY # 10
SUITE 4C
WOODSTOCK, VT
ZIP 05091-162
Phone: (802) 457-1903
Fax: (802) 457-3619

The provider's authorized official is Jedidiah L Janisse .
The authorized official title is President and has the following contact phone number (802) 457-1903.

The enumeration date for this NPI number is 12/17/2008 and was last updated on 10/11/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1122300000XDentist016-0002247VERMONTNo
2261QS0112XClinic/CenterOral and Maxillofacial SurgeryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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