Provider Demographics
NPI:1699915546
Name:JONES DENTISTRY P. S.
Entity type:Organization
Organization Name:JONES DENTISTRY P. S.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:G
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PS
Authorized Official - Phone:509-590-7570
Mailing Address - Street 1:4610 N ASH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-1482
Mailing Address - Country:US
Mailing Address - Phone:509-326-2660
Mailing Address - Fax:
Practice Address - Street 1:4610 N ASH ST STE 101
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-1482
Practice Address - Country:US
Practice Address - Phone:509-326-2660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-04
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000105741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5058144Medicaid
WA5023189Medicaid
WA5058151Medicaid