Provider Demographics
NPI:1205943677
Name:JONES, DOUGLAS W (DDS)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:W
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 1:2100 CARLMONT DR
Mailing Address - Street 2:#8
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002
Mailing Address - Country:US
Mailing Address - Phone:650-591-1984
Mailing Address - Fax:650-591-0138
Practice Address - Street 1:2100 CARLMONT DR
Practice Address - Street 2:#8
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002
Practice Address - Country:US
Practice Address - Phone:650-591-1984
Practice Address - Fax:650-591-0138
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32098122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist