Provider Demographics
NPI:1548388747
Name:ILKKA, DON JOHN (DDS)
Entity type:Individual
Prefix:DR
First Name:DON
Middle Name:JOHN
Last Name:ILKKA
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 1:8301 COUNTY ROAD 44 LEG A
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34788-3706
Mailing Address - Country:US
Mailing Address - Phone:352-589-0551
Mailing Address - Fax:
Practice Address - Street 1:8301 COUNTY ROAD 44 LEG A
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34788-3706
Practice Address - Country:US
Practice Address - Phone:352-589-0551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 92391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice