Provider Demographics
NPI:1811588486
Name:JONES DENTAL PARTNERS
Entity Type:Organization
Organization Name:JONES DENTAL PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WYATT
Authorized Official - Middle Name:S
Authorized Official - Last Name:DANNELS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-209-5722
Mailing Address - Street 1:4750 W SAHARA AVE STE 12
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-3559
Mailing Address - Country:US
Mailing Address - Phone:702-522-1929
Mailing Address - Fax:
Practice Address - Street 1:240 N JONES BLVD STE B
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-1450
Practice Address - Country:US
Practice Address - Phone:702-522-1929
Practice Address - Fax:702-475-6504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty