Provider Demographics
NPI:1316470032
Name:LEONE, ERICA (DDS)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:LEONE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 POIPU RD APT 533
Mailing Address - Street 2:
Mailing Address - City:KOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96756-9586
Mailing Address - Country:US
Mailing Address - Phone:336-269-3745
Mailing Address - Fax:808-320-3329
Practice Address - Street 1:3-3359 KUHIO HWY
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1061
Practice Address - Country:US
Practice Address - Phone:808-378-4869
Practice Address - Fax:808-320-3329
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11282122300000X, 1223P0221X
HI28811223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist