Provider Demographics
NPI:1255617221
Name:JONES, DENA T (DC)
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:T
Last Name:JONES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2181 NORTHLAKE PKWY
Mailing Address - Street 2:SUITE 120, BLD 6
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-4107
Mailing Address - Country:US
Mailing Address - Phone:770-934-4233
Mailing Address - Fax:770-934-4234
Practice Address - Street 1:2181 NORTHLAKE PKWY
Practice Address - Street 2:SUITE 120, BLD 6
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4107
Practice Address - Country:US
Practice Address - Phone:770-934-4233
Practice Address - Fax:770-934-4234
Is Sole Proprietor?:No
Enumeration Date:2011-10-22
Last Update Date:2011-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008881111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA26-3894919OtherATLANTA ACCIDENT & INJ SPEC - TAX ID (TUCKER CLINIC)