Provider Demographics
NPI:1134211709
Name:JANECKE, DENNIS E (DDS)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:E
Last Name:JANECKE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 BRANDON BLVD
Mailing Address - Street 2:
Mailing Address - City:EAST GRAND FORKS
Mailing Address - State:MN
Mailing Address - Zip Code:56721-4801
Mailing Address - Country:US
Mailing Address - Phone:406-498-7191
Mailing Address - Fax:
Practice Address - Street 1:212 S 4TH ST STE 200
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-4781
Practice Address - Country:US
Practice Address - Phone:406-498-7191
Practice Address - Fax:406-723-3059
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT22081223G0001X
ND24891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice