Provider Demographics
NPI:1063136463
Name:NINA H. JONES DDS, LLC
Entity type:Organization
Organization Name:NINA H. JONES DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NINA
Authorized Official - Middle Name:H
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:803-754-9160
Mailing Address - Street 1:745 UNIVERSITY VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016-7613
Mailing Address - Country:US
Mailing Address - Phone:803-754-9160
Mailing Address - Fax:803-754-9162
Practice Address - Street 1:745 UNIVERSITY VILLAGE DR
Practice Address - Street 2:
Practice Address - City:BLYTHEWOOD
Practice Address - State:SC
Practice Address - Zip Code:29016-7613
Practice Address - Country:US
Practice Address - Phone:803-754-9160
Practice Address - Fax:803-754-9162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-29
Last Update Date:2022-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty