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NPI Code Detail

MEDICARE: DEMETRA CORRINE JONES DDS

MEDICARE: DEMETRA CORRINE 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
11223G0001XGeneral Practice Dentistry19340TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396844221
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEMETRA CORRINE JONES DDS
Provider Business Mailing Address
First Line : 3408 SILVERWOOD LN
Second Line :
City : DALLAS
State : TX
Zip : 75233-2614
Country : US
Telephone Number : 214-337-5847
Fax Number : 214-565-7952
Provider Business Practice Location Address
First Line : 4432 MALCOLM X BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75215-4349
Country : US
Telephone Number : 214-565-4330
Fax Number : 214-565-7952
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 07/08/2007

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Directions to “ DEMETRA CORRINE JONES DDS” Practice Location

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