Provider Demographics
NPI:1538277991
Name:GRAY, ANGELA JONES (DDS)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:JONES
Last Name:GRAY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ANGELA
Other - Middle Name:LATRENDA
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:8700 IRON HORSE DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-3915
Mailing Address - Country:US
Mailing Address - Phone:214-697-3038
Mailing Address - Fax:
Practice Address - Street 1:8905 LAKEVIEW PARKWAY
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088
Practice Address - Country:US
Practice Address - Phone:214-948-3364
Practice Address - Fax:214-948-1339
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21173122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164033601Medicaid