Healthcare Provider Details

I. General information

NPI: 1104555473
Provider Name (Legal Business Name): DANIELLE LEOTA JONES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1161 E DAYTON YELLOW SPRINGS RD
FAIRBORN OH
45324-6325
US

IV. Provider business mailing address

3922 ODIN AVE
CINCINNATI OH
45213-1926
US

V. Phone/Fax

Practice location:
  • Phone: 937-318-3920
  • Fax: 937-318-3921
Mailing address:
  • Phone: 937-830-9052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03441876
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03441876
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: