Provider Demographics
NPI:1013687219
Name:JONES, DENNIS RANDELL
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:RANDELL
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 732
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22216-0732
Mailing Address - Country:US
Mailing Address - Phone:703-220-2682
Mailing Address - Fax:703-229-6372
Practice Address - Street 1:1529 KINNAIRD TER NE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-6591
Practice Address - Country:US
Practice Address - Phone:703-220-2682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-18
Last Update Date:2021-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date: