Provider Demographics
NPI:1427126002
Name:JONES, JUDITH ANN (DDS, MPH, DSCD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:ANN
Last Name:JONES
Suffix:
Gender:F
Credentials:DDS, MPH, DSCD
Other - Prefix:MRS
Other - First Name:JUDITH
Other - Middle Name:ANN
Other - Last Name:FITZMAURICE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS, MPH, DSCD
Mailing Address - Street 1:3 OLDE HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-1714
Mailing Address - Country:US
Mailing Address - Phone:978-663-5142
Mailing Address - Fax:
Practice Address - Street 1:200 SPRINGS RD
Practice Address - Street 2:VAMC-152
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-1114
Practice Address - Country:US
Practice Address - Phone:781-687-3161
Practice Address - Fax:781-687-3106
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4499122300000X
MA15701122300000X
MI29010126711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223G0001XDental ProvidersDentistGeneral Practice