Provider Demographics
NPI:1942513189
Name:JONES, CASSANDRA LORRAINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:LORRAINE
Last Name:JONES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 MACON CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2094
Mailing Address - Country:US
Mailing Address - Phone:646-594-5400
Mailing Address - Fax:
Practice Address - Street 1:8115 MARKET ST STE 204
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-8430
Practice Address - Country:US
Practice Address - Phone:910-409-6025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11765122300000X
MADN1855492122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist