Provider Demographics
NPI:1841602380
Name:JONES, JILL (BSDH, RDH, MS)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:BSDH, RDH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3380 SOUTHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-6243
Mailing Address - Country:US
Mailing Address - Phone:541-344-5919
Mailing Address - Fax:
Practice Address - Street 1:2640 WILLAMETTE ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405
Practice Address - Country:US
Practice Address - Phone:541-463-5206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH-3002124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist