Provider Demographics
NPI:1609873470
Name:JONES, RONALD D (DMD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:D
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 1:3720 SPICER DR SE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-7044
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:810 WALNUT ST SW
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2438
Practice Address - Country:US
Practice Address - Phone:541-928-1635
Practice Address - Fax:541-924-9664
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2011-03-31
Deactivation Date:2006-03-25
Deactivation Code:
Reactivation Date:2006-06-28
Provider Licenses
StateLicense IDTaxonomies
ORD5516122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist