Provider Demographics
NPI:1750609426
Name:ROBERT L. JONES, D.D.S., P.C.
Entity type:Organization
Organization Name:ROBERT L. JONES, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:202-882-1115
Mailing Address - Street 1:7603 GEORGIA AVE NW
Mailing Address - Street 2:STE. 403
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-1617
Mailing Address - Country:US
Mailing Address - Phone:202-882-1115
Mailing Address - Fax:202-882-1127
Practice Address - Street 1:7603 GEORGIA AVE NW
Practice Address - Street 2:STE. 403
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1617
Practice Address - Country:US
Practice Address - Phone:202-882-1115
Practice Address - Fax:202-882-1127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC021985300Medicaid
000164461Medicare UPIN