Provider Demographics
NPI:1568899557
Name:JONES, MIATA (DDS)
Entity Type:Individual
Prefix:
First Name:MIATA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 N WASHINGTON ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3439
Mailing Address - Country:US
Mailing Address - Phone:703-538-2806
Mailing Address - Fax:
Practice Address - Street 1:450 N WASHINGTON ST
Practice Address - Street 2:SUITE D
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3439
Practice Address - Country:US
Practice Address - Phone:703-538-2806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-04
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014120071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice