Provider Demographics
NPI:1851508725
Name:JONES, JEFFREY THOMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:THOMAS
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 1:1467 N WANDA RD
Mailing Address - Street 2:SU 105
Mailing Address - City:VILLA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:92867-5344
Mailing Address - Country:US
Mailing Address - Phone:714-771-1204
Mailing Address - Fax:714-771-3589
Practice Address - Street 1:1467 N WANDA RD
Practice Address - Street 2:SU 105
Practice Address - City:VILLA PARK
Practice Address - State:CA
Practice Address - Zip Code:92867-5344
Practice Address - Country:US
Practice Address - Phone:714-771-1204
Practice Address - Fax:714-771-3589
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA330471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice