Provider Demographics
NPI:1194568014
Name:JANTON, JESSICA LEILA (DMD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LEILA
Last Name:JANTON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 BROOKMOOR RD
Mailing Address - Street 2:
Mailing Address - City:TOLLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06084-2501
Mailing Address - Country:US
Mailing Address - Phone:860-335-2148
Mailing Address - Fax:
Practice Address - Street 1:50 HALE ST
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-3840
Practice Address - Country:US
Practice Address - Phone:860-872-0794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT141171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice