MEDICARE: DR. MELANIE VENTOCILLA JONES DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	0401414660	VA

General Provider Information

NPI Number	:	1053705517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELANIE VENTOCILLA JONES DDS

Provider Business Mailing Address
First Line	:	4029 ELLICOTT ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-1011
Country	:	US
Telephone Number	:	571-220-9164
Fax Number	:

Provider Business Practice Location Address
First Line	:	6303 LITTLE RIVER TPKE STE 160
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22312-5045
Country	:	US
Telephone Number	:	703-942-8404
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2015
Last Update Date	:	02/03/2026

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