Healthcare Provider Details

I. General information

NPI: 1306703715
Provider Name (Legal Business Name): LORI A JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3211 COORS BLVD SW STE D2
ALBUQUERQUE NM
87121-5255
US

IV. Provider business mailing address

2506 RIVER SLATE CT
KINGWOOD TX
77345-1512
US

V. Phone/Fax

Practice location:
  • Phone: 505-336-7451
  • Fax:
Mailing address:
  • Phone: 337-353-9710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number5592
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: