Healthcare Provider Details

I. General information

NPI: 1912657461
Provider Name (Legal Business Name): VICTORIA LYNNE JANUS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2022
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8501 LASALLE RD #306
TOWSON MD
21286
US

IV. Provider business mailing address

25 HOOKS LN #212
BALTIMORE MD
21208
US

V. Phone/Fax

Practice location:
  • Phone: 410-296-7599
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number17941
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number018.002211
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: