Basic Information
Provider Information
NPI: 1134553498
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: APT
FirstName: JANET
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: RDH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3011 N MICHIGAN ST
Address2:  
City: PITTSBURG
State: KS
PostalCode: 667622546
CountryCode: US
TelephoneNumber: 6202319873
FaxNumber: 6202312808
Practice Location
Address1: 1408 EAST ST
Address2: SUITE C
City: IOLA
State: KS
PostalCode: 667494402
CountryCode: US
TelephoneNumber: 6203656400
FaxNumber: 6203656402
Other Information
ProviderEnumerationDate: 08/22/2013
LastUpdateDate: 08/22/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
124Q00000X1052KSY Dental ProvidersDental Hygienist 

No ID Information.


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