Provider Demographics
NPI:1588833461
Name:DEARMOND AND JONES DDS PC
Entity Type:Organization
Organization Name:DEARMOND AND JONES DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EBEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:DEARMOND
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:423-476-7696
Mailing Address - Street 1:150 20TH STREET NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311
Mailing Address - Country:US
Mailing Address - Phone:423-476-7696
Mailing Address - Fax:423-476-4115
Practice Address - Street 1:150 20TH STREET NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311
Practice Address - Country:US
Practice Address - Phone:423-476-7696
Practice Address - Fax:423-476-4115
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEARMOND AND JONES DDS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS39551223G0001X
TNDS46651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty