Provider Demographics
NPI:1831100122
Name:JONES, NEAL B (DDS)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:B
Last Name:JONES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14001 SAINT GERMAIN DRIVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-2338
Mailing Address - Country:US
Mailing Address - Phone:703-802-0630
Mailing Address - Fax:703-802-1407
Practice Address - Street 1:14001 SAINT GERMAIN DRIVE
Practice Address - Street 2:SUITE B
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-2338
Practice Address - Country:US
Practice Address - Phone:703-802-0630
Practice Address - Fax:703-802-1407
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401007127122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7830173Medicaid