Provider Demographics
NPI:1700219128
Name:JONES HINDBAUGH, ERICA LYNN (DDS)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:LYNN
Last Name:JONES HINDBAUGH
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 1:4602 VALLEY WEST BLVD
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-4636
Mailing Address - Country:US
Mailing Address - Phone:707-822-4689
Mailing Address - Fax:707-822-1400
Practice Address - Street 1:4602 VALLEY WEST BLVD
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-4636
Practice Address - Country:US
Practice Address - Phone:707-822-4689
Practice Address - Fax:707-822-1400
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54573122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist