Provider Demographics
NPI:1225094196
Name:GOLD, JAANA TUULIKKI (DDS, PHD)
Entity Type:Individual
Prefix:DR
First Name:JAANA
Middle Name:TUULIKKI
Last Name:GOLD
Suffix:
Gender:F
Credentials:DDS, PHD
Other - Prefix:DR
Other - First Name:JAANA
Other - Middle Name:T
Other - Last Name:AUTIO-GOLD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, PHD
Mailing Address - Street 1:PO BOX 100405
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0405
Mailing Address - Country:US
Mailing Address - Phone:352-273-5841
Mailing Address - Fax:352-392-3070
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:D4-4
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-273-5800
Practice Address - Fax:352-392-3070
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDTP 204122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBA 7126368OtherDEA