Healthcare Provider Details

I. General information

NPI: 1013350677
Provider Name (Legal Business Name): JASON ALLEN JONES D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2013
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7150 N 7TH ST
PHOENIX AZ
85020-5304
US

IV. Provider business mailing address

18478 N 97TH WAY
SCOTTSDALE AZ
85255-2552
US

V. Phone/Fax

Practice location:
  • Phone: 284-823-5189
  • Fax:
Mailing address:
  • Phone: 904-386-5479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8929
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: