# JANSEN FAMILY DENTISTRY, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952351264
- **Authorized official:** SUSAN JANSEN (BUSINESS MANAGER)
- **Authorized official phone:** (260) 347-5115

## Contact information

- **Practice address:** 230 S MAIN STREET, KENDALLVILLE, IN 46755-1718
- **Practice address phone:** (260) 347-5115
- **Practice address fax:** (260) 347-9098
- **Mailing address:** 230 S MAIN STREET, KENDALLVILLE, IN 46755-1718
- **Mailing address phone:** (260) 347-5115
- **Mailing address fax:** (260) 347-9098

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/10/2006
- **Last updated:** 07/22/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100190860A | — | IN |
| 05 | — | 200389980A | — | IN |