MEDICARE: ZACHARY JONES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	17265	MD

General Provider Information

NPI Number	:	1962866350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY JONES

Provider Business Mailing Address
First Line	:	6201 GREENBELT RD STE M1
Second Line	:
City	:	BERWYN HEIGHTS
State	:	MD
Zip	:	20740-2358
Country	:	US
Telephone Number	:	301-345-7007
Fax Number	:

Provider Business Practice Location Address
First Line	:	6201 GREENBELT RD STE M1
Second Line	:
City	:	BERWYN HEIGHTS
State	:	MD
Zip	:	20740-2358
Country	:	US
Telephone Number	:	301-345-7007
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2016
Last Update Date	:	04/14/2021

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