Provider Demographics
NPI:1346243383
Name:JONES, HARRY E (DDS)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:E
Last Name:JONES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:HAL
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:6015 SHALLOWFORD ROAD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1688
Mailing Address - Country:US
Mailing Address - Phone:423-893-3333
Mailing Address - Fax:423-954-3054
Practice Address - Street 1:6015 SHALLOWFORD ROAD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1688
Practice Address - Country:US
Practice Address - Phone:423-893-3333
Practice Address - Fax:423-954-3054
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3941204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0125547OtherBCBSTN PROVIDER NUMBER
TN4665172OtherAETNA PROVIDER NUMBER
TN3225458Medicaid
TN4665172OtherAETNA PROVIDER NUMBER
TN3225458Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE NUMBE
TNT74440Medicare UPIN