Provider Demographics
NPI:1083734164
Name:JONES, PAULA SHANNON (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:SHANNON
Last Name:JONES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:JO
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1341 BRANCHWOOD CIR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-0487
Mailing Address - Country:US
Mailing Address - Phone:630-369-4506
Mailing Address - Fax:
Practice Address - Street 1:1341 BRANCHWOOD CIR
Practice Address - Street 2:SUITE 202
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-0487
Practice Address - Country:US
Practice Address - Phone:630-369-4506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice