Active NPI
Ethan Mark Jones, DDS
- Dentist
- Centerville, OH
National Provider Identifier
1578090544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30025041
- Practice address
- 9420 Dayton Lebanon Pike
Centerville, OH 45458-3860 - Phone
- (937) 433-8900
- NPI assigned
- May 21, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30025041 | OH | Primary |
Addresses
Primary practice location
9420 Dayton Lebanon Pike
Centerville, OH 45458-3860
Mailing address
9420 Dayton Lebanon Pike
Centerville, OH 45458-3860
Phone (937) 433-8900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30025041 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495324800000",
"number": "1578090544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9420 DAYTON LEBANON PIKE",
"city": "CENTERVILLE",
"state": "OH",
"postal_code": "454583860",
"telephone_number": "937-433-8900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9420 DAYTON LEBANON PIKE",
"city": "CENTERVILLE",
"state": "OH",
"postal_code": "454583860",
"telephone_number": "937-433-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "ETHAN",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-21",
"last_updated": "2017-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30025041",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centerville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.