Provider Demographics
NPI:1710061320
Name:JONES, MICHAEL BRANDON (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRANDON
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 1:2025 W 200 N STE 1
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-4300
Mailing Address - Country:US
Mailing Address - Phone:801-544-3233
Mailing Address - Fax:
Practice Address - Street 1:2025 W 200 N STE 1
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037
Practice Address - Country:US
Practice Address - Phone:801-544-3323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30022427122300000X
UT6509903-99231223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist