Provider Demographics
NPI:1225211550
Name:AVERY, JONI MICHEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JONI
Middle Name:MICHEL
Last Name:AVERY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 EASTLAND COUNTY ROAD 493
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:TX
Mailing Address - Zip Code:76446-8000
Mailing Address - Country:US
Mailing Address - Phone:972-207-4563
Mailing Address - Fax:
Practice Address - Street 1:117 N GRAFTON ST
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:TX
Practice Address - Zip Code:76446-1907
Practice Address - Country:US
Practice Address - Phone:254-445-2442
Practice Address - Fax:254-445-4779
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-10
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice