MEDICARE: SUSAN BARR JONES DMD

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	122300000X	Dentist	8292	NC
2	122300000X	Dentist	DN14318	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8292	OTHER	NC	NORTH CAROLINA LICENSE
2	DN14318	OTHER	FL	FLORIDA STATE LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134154693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN BARR JONES DMD

Provider Business Mailing Address
First Line	:	128 HERON POINT LN
Second Line	:
City	:	WOODBINE
State	:	GA
Zip	:	31569-4073
Country	:	US
Telephone Number	:	910-988-7602
Fax Number	:

Provider Business Practice Location Address
First Line	:	8209 W BEAVER ST STE 100
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32220-2393
Country	:	US
Telephone Number	:	904-293-1931
Fax Number	:

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	08/29/2025

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Directions to “ SUSAN BARR JONES DMD” Practice Location

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