Provider Demographics
NPI:1396981155
Name:JONES, ROBERT S (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
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 1:2200 E FRUIT ST
Mailing Address - Street 2:#208
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-4479
Mailing Address - Country:US
Mailing Address - Phone:714-543-2636
Mailing Address - Fax:714-542-7118
Practice Address - Street 1:2200 E FRUIT ST
Practice Address - Street 2:#208
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4479
Practice Address - Country:US
Practice Address - Phone:714-543-2636
Practice Address - Fax:714-542-7118
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA034977122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist