Healthcare Provider Details

I. General information

NPI: 1306132030
Provider Name (Legal Business Name): COURTNEY PERKINS JONES D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8894 AIRLINE HWY SUITE M
BATON ROUGE LA
70815-4081
US

IV. Provider business mailing address

4802 JONES CREEK RD STE D
BATON ROUGE LA
70817-1527
US

V. Phone/Fax

Practice location:
  • Phone: 225-218-9218
  • Fax: 225-218-9219
Mailing address:
  • Phone: 225-369-9665
  • Fax: 225-341-8764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6175
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6175
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: