Provider Demographics
NPI:1487875753
Name:LEONE, JAY (DDS)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:
Last Name:LEONE
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 1:6144 INDIANOLA AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-2016
Mailing Address - Country:US
Mailing Address - Phone:317-523-3355
Mailing Address - Fax:
Practice Address - Street 1:1020 W OAK ST
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-1257
Practice Address - Country:US
Practice Address - Phone:317-873-5344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010632B122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist