Healthcare Provider Details

I. General information

NPI: 1225211550
Provider Name (Legal Business Name): JONI MICHEL AVERY D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 02/14/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 N GRAFTON ST
DUBLIN TX
76446-1907
US

IV. Provider business mailing address

410 EASTLAND COUNTY ROAD 493
DUBLIN TX
76446-8000
US

V. Phone/Fax

Practice location:
  • Phone: 254-445-2442
  • Fax: 254-445-4779
Mailing address:
  • Phone: 972-207-4563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number20281
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: