Provider Demographics
NPI:1992497697
Name:JONES, CAILAN CHRISTOPHER (DMD)
Entity type:Individual
Prefix:
First Name:CAILAN
Middle Name:CHRISTOPHER
Last Name:JONES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 HOBBS LN
Mailing Address - Street 2:
Mailing Address - City:COXS CREEK
Mailing Address - State:KY
Mailing Address - Zip Code:40013-7788
Mailing Address - Country:US
Mailing Address - Phone:502-349-3472
Mailing Address - Fax:
Practice Address - Street 1:810 MORTON AVE STE 200
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-2549
Practice Address - Country:US
Practice Address - Phone:502-348-9944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY109421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice