Healthcare Provider Details

I. General information

NPI: 1861740920
Provider Name (Legal Business Name): JANET LOY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2012
Last Update Date: 08/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6817 SOUTHPOINT PKWY SUITE 302
JACKSONVILLE FL
32216-6282
US

IV. Provider business mailing address

11836 MINFORD CIR S
JACKSONVILLE FL
32246-1703
US

V. Phone/Fax

Practice location:
  • Phone: 904-296-6820
  • Fax:
Mailing address:
  • Phone: 904-860-8656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN 19948
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH 17599
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: