Provider Demographics
NPI:1568046092
Name:LECROIX, DEANNA ELLENE (DDS)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:ELLENE
Last Name:LECROIX
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 1:35 E KEMPER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-3224
Mailing Address - Country:US
Mailing Address - Phone:513-642-0002
Mailing Address - Fax:
Practice Address - Street 1:3116 MONTGOMERY ROAD
Practice Address - Street 2:UNIT 1
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039
Practice Address - Country:US
Practice Address - Phone:513-334-4060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300264561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice