Provider Demographics
NPI:1376739292
Name:JONES, JOSHUA JOHNATHAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:JOHNATHAN
Last Name:JONES
Suffix:
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 1:305 GRETNA BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70053
Mailing Address - Country:US
Mailing Address - Phone:504-368-8152
Mailing Address - Fax:504-368-7104
Practice Address - Street 1:305 GRETNA BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053
Practice Address - Country:US
Practice Address - Phone:504-368-8152
Practice Address - Fax:504-368-7104
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA56451223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics