Provider Demographics
NPI:1689726283
Name:JONES, JACKIE FELDA JR (DMD)
Entity Type:Individual
Prefix:MR
First Name:JACKIE
Middle Name:FELDA
Last Name:JONES
Suffix:JR
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:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:ACKERMAN
Mailing Address - State:MS
Mailing Address - Zip Code:39735-0068
Mailing Address - Country:US
Mailing Address - Phone:662-285-6828
Mailing Address - Fax:662-285-6896
Practice Address - Street 1:11 NORTH LOUISVILLE ST
Practice Address - Street 2:
Practice Address - City:ACKERMAN
Practice Address - State:MS
Practice Address - Zip Code:39735
Practice Address - Country:US
Practice Address - Phone:662-285-6828
Practice Address - Fax:662-285-6896
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS21821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice