Provider Demographics
NPI:1134764327
Name:JONES, JUSTIN ALVIN (DDS)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:ALVIN
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 1:810 BELMONT BAY DR APT 304
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-5464
Mailing Address - Country:US
Mailing Address - Phone:202-246-9609
Mailing Address - Fax:
Practice Address - Street 1:2750 W 29TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3714
Practice Address - Country:US
Practice Address - Phone:303-477-7776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00204162122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist