Individual provider Active NPI

Charles E Jones Jr., D.D.S.

  • General Practice Dentistry
  • Brookings, OR
National Provider Identifier
1063411353
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D8569 Issued in OR
Practice address
616 5TH St
Brookings, OR 97415-9199
Phone
(541) 469-3513
Fax
(541) 469-5479
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D8569 OR Primary

Addresses

Primary practice location

616 5TH St
Brookings, OR 97415-9199

Mailing address

616 5TH St
Brookings, OR 97415-9199
Phone (541) 469-3513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200826002750 OR Order and Referring Only - DentistPractitioner - Dentist 8325465040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D8569ORMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063411353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 5TH ST",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974159199",
            "telephone_number": "541-469-3513",
            "fax_number": "541-469-5479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 5TH ST",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974159199",
            "telephone_number": "541-469-3513",
            "fax_number": "541-469-5479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "CHARLES",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D8569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookings, OR

Sources for this page

Verify at the official NPI Registry.