Provider Demographics
NPI:1699735381
Name:JONES-SYLLA, DAWN NICHOLE (DMD)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:NICHOLE
Last Name:JONES-SYLLA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10035
Mailing Address - Country:US
Mailing Address - Phone:212-860-1660
Mailing Address - Fax:212-860-1664
Practice Address - Street 1:1825 MADISON AVE
Practice Address - Street 2:
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10035
Practice Address - Country:US
Practice Address - Phone:212-860-1660
Practice Address - Fax:212-860-1664
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-25
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0524261223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02698364Medicaid