Provider Demographics
NPI:1437615721
Name:ANDONE, NOAH (DDS)
Entity Type:Individual
Prefix:DR
First Name:NOAH
Middle Name:
Last Name:ANDONE
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 1:1584 KINGSLEY AVE STE B
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4515
Mailing Address - Country:US
Mailing Address - Phone:904-264-5437
Mailing Address - Fax:
Practice Address - Street 1:1584 KINGSLEY AVE STE B
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4515
Practice Address - Country:US
Practice Address - Phone:904-264-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-12
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN245771223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty