Provider Demographics
NPI:1982741104
Name:JONES, ROBERT LEE (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEE
Last Name:JONES
Suffix:
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 1:6400 GOLDLEAF DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-5830
Mailing Address - Country:US
Mailing Address - Phone:301-229-9414
Mailing Address - Fax:301-229-9594
Practice Address - Street 1:7603 GEORGIA AVE NW
Practice Address - Street 2:STE 403
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1617
Practice Address - Country:US
Practice Address - Phone:202-882-1115
Practice Address - Fax:202-882-1127
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN27671223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC021985300Medicaid
DC000164461Medicare ID - Type Unspecified