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Contact Information

JAN RYAN DANE, DMD
PETESA ROAD
PAGO PAGO, AS96799
 Phone: 684-699-6380
 Fax: 684-699-6374
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for JAN RYAN DANE · (Male)

NPI # 1356884381
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 11/22/2016
Last updated 11/23/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • AS License # 4071-C
  • AS Medicaid 9740676
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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