Provider Demographics
NPI:1780609537
Name:JONES, HAYDN GEORGE II (DDS)
Entity type:Individual
Prefix:DR
First Name:HAYDN
Middle Name:GEORGE
Last Name:JONES
Suffix:II
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 1:1816 EAST BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5826
Mailing Address - Country:US
Mailing Address - Phone:704-333-6714
Mailing Address - Fax:704-334-3644
Practice Address - Street 1:1816 EAST BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5826
Practice Address - Country:US
Practice Address - Phone:704-333-6714
Practice Address - Fax:704-334-3644
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC64451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8994708Medicaid
NC94708OtherBCBS OF NC