Provider Demographics
NPI:1467491035
Name:JONES, EMMETT M (DDS)
Entity Type:Individual
Prefix:DR
First Name:EMMETT
Middle Name:M
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 1:3745 HENDERSON DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-5237
Mailing Address - Country:US
Mailing Address - Phone:910-455-2151
Mailing Address - Fax:910-455-6977
Practice Address - Street 1:3745 HENDERSON DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-5237
Practice Address - Country:US
Practice Address - Phone:910-577-3233
Practice Address - Fax:910-455-6977
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC5203122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC94722OtherBLUE CROSS & BLUE SHEILD
MAZQC146OtherBLUE CROSS & BLUE SHEILD
NC826351OtherUNITED CONCORDIA