Provider Demographics
NPI:1306132030
Name:JONES, COURTNEY PERKINS (DDS)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:PERKINS
Last Name:JONES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4802 JONES CREEK RD STE D
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-1527
Mailing Address - Country:US
Mailing Address - Phone:225-369-9665
Mailing Address - Fax:225-341-8764
Practice Address - Street 1:8894 AIRLINE HWY
Practice Address - Street 2:SUITE M
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815-4081
Practice Address - Country:US
Practice Address - Phone:225-218-9218
Practice Address - Fax:225-218-9219
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA61751223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1861758Medicaid