Healthcare Provider Details

I. General information

NPI: 1982402921
Provider Name (Legal Business Name): IRIE DANAE JONES DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13730 MILLERVILLE GREENS BLVD # 1
BATON ROUGE LA
70816-1696
US

IV. Provider business mailing address

13730 MILLERVILLE GREENS BLVD
BATON ROUGE LA
70816-1696
US

V. Phone/Fax

Practice location:
  • Phone: 225-234-0713
  • Fax:
Mailing address:
  • Phone: 225-234-0713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number7840
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: