Provider Demographics
NPI:1043353147
Name:JONES, EARL III (DDS)
Entity Type:Individual
Prefix:DR
First Name:EARL
Middle Name:
Last Name:JONES
Suffix:III
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 1:6534 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-2017
Mailing Address - Country:US
Mailing Address - Phone:510-569-1817
Mailing Address - Fax:510-569-5399
Practice Address - Street 1:6534 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2017
Practice Address - Country:US
Practice Address - Phone:510-569-1817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADL0322481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB32248-01OtherDENTI- CAL