Healthcare Provider Details

I. General information

NPI: 1346893484
Provider Name (Legal Business Name): JONI MICHELLE WATSON DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32576 WILDERNESS RD
JONESVILLE VA
24263-7006
US

IV. Provider business mailing address

32576 WILDERNESS RD
JONESVILLE VA
24263-7006
US

V. Phone/Fax

Practice location:
  • Phone: 276-546-3121
  • Fax: 276-546-3636
Mailing address:
  • Phone: 276-546-3121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401416597
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: