=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013276633
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DAVID R. JONES, D.D.S., INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/16/2012
-----------------------------------------------------
Last Update Date | 05/12/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7112 ED BLUESTEIN BLVD STE 100
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78723-2913
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-744-6000
-----------------------------------------------------
Fax | 512-744-6055
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9411 N LAMAR BLVD STE 120
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78753-4179
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-583-9679
-----------------------------------------------------
Fax | 512-233-0985
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DAVID R JONES
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 512-583-9679
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------