Provider Demographics
NPI:1437389525
Name:JONES, JEREMY J (DMD)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:J
Last Name:JONES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 FAYETTE STREET
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202
Mailing Address - Country:US
Mailing Address - Phone:765-749-7109
Mailing Address - Fax:765-749-7109
Practice Address - Street 1:7015 US 31 S
Practice Address - Street 2:SUITE D
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-8611
Practice Address - Country:US
Practice Address - Phone:765-749-7109
Practice Address - Fax:765-749-7109
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME41171223G0001X
IN12011781A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice