Provider Demographics
NPI:1063941961
Name:JONES, JANE KATHERINE (DMD)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:KATHERINE
Last Name:JONES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:JANE
Other - Middle Name:K
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:2308 THE WOODS LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-9002
Mailing Address - Country:US
Mailing Address - Phone:859-229-9973
Mailing Address - Fax:
Practice Address - Street 1:105 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40507-2109
Practice Address - Country:US
Practice Address - Phone:859-229-9973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-06
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9926122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100467830Medicaid