MEDICARE: DR. JEFFREY M. 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	1223G0001X	General Practice Dentistry	12011160A	IN

General Provider Information

NPI Number	:	1598924698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY M. JONES DDS

Provider Business Mailing Address
First Line	:	4805 CHANTILLY DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46221-2903
Country	:	US
Telephone Number	:	317-431-1287
Fax Number	:

Provider Business Practice Location Address
First Line	:	2248 E 53RD ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-3479
Country	:	US
Telephone Number	:	317-472-9888
Fax Number	:

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

Provider Enumeration Date	:	06/03/2008
Last Update Date	:	06/03/2008

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