Provider Demographics
NPI:1083435960
Name:JONES, KENNETH L II (DDS)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:L
Last Name:JONES
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ALLISON DR APT 246
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-4992
Mailing Address - Country:US
Mailing Address - Phone:707-515-9417
Mailing Address - Fax:
Practice Address - Street 1:179 ELMIRA RD STE H
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-4732
Practice Address - Country:US
Practice Address - Phone:707-446-6236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1105751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice