Provider Demographics
NPI:1548753825
Name:JONES, MELISSA ANN (DMD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:JONES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 WILMINGTON CIR
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6188
Mailing Address - Country:US
Mailing Address - Phone:407-454-4783
Mailing Address - Fax:
Practice Address - Street 1:3680 W GANDY BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33611-2608
Practice Address - Country:US
Practice Address - Phone:813-820-0063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN23354122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist