Provider Demographics
NPI:1275691917
Name:JONES, MARK E (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:E
Last Name:JONES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9535 RESEDA BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-2310
Mailing Address - Country:US
Mailing Address - Phone:818-708-3790
Mailing Address - Fax:818-708-3785
Practice Address - Street 1:9535 RESEDA BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-2310
Practice Address - Country:US
Practice Address - Phone:818-708-3790
Practice Address - Fax:818-708-3785
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18351122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist