Provider Demographics
NPI:1548640188
Name:JONES, BRADY JOSEPH (DMD)
Entity type:Individual
Prefix:
First Name:BRADY
Middle Name:JOSEPH
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 1:106 ISLAND PLUMERIA LN
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-6448
Mailing Address - Country:US
Mailing Address - Phone:928-322-7396
Mailing Address - Fax:
Practice Address - Street 1:670 S GREEN VALLEY PKWY STE 115
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-0434
Practice Address - Country:US
Practice Address - Phone:702-685-3700
Practice Address - Fax:702-685-3701
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS2-2061223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery