Provider Demographics
NPI:1609977438
Name:JONES, JEFFREY PAUL (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:PAUL
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 1:11 MAREBLU
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-3044
Mailing Address - Country:US
Mailing Address - Phone:949-643-3210
Mailing Address - Fax:949-454-0641
Practice Address - Street 1:11 MAREBLU
Practice Address - Street 2:SUITE 140
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-3044
Practice Address - Country:US
Practice Address - Phone:949-643-3210
Practice Address - Fax:949-454-0641
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA296091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice