Provider Demographics
NPI:1669801569
Name:JONES, CHAD (DDS)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:
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 1:55 M ST SE STE 103
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-3563
Mailing Address - Country:US
Mailing Address - Phone:202-670-4882
Mailing Address - Fax:202-600-2837
Practice Address - Street 1:55 M ST SE STE 103
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3522
Practice Address - Country:US
Practice Address - Phone:202-670-4882
Practice Address - Fax:202-600-2837
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD156251223G0001X, 1223G0001X
DCDEN10013351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC070703500Medicaid