Provider Demographics
NPI:1871585448
Name:JONES, TIFFANY A (RDH)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5277 MAGNOLIA CIR N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-5234
Mailing Address - Country:US
Mailing Address - Phone:904-743-0468
Mailing Address - Fax:
Practice Address - Street 1:USS JOHN F. KENNEDY CV-67
Practice Address - Street 2:1562 MITSCHER AVE SUITE 250
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23551-0001
Practice Address - Country:US
Practice Address - Phone:904-270-5602
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7249124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist