Treacy Douglas Jones, DDS FAGD
Individual provider Active NPI General Practice Dentistry · Verona, VA
NPI 1669558995 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1669558995
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 0401410527 (VA)
- Practice address
- 56 Quicks Mill Rd
Verona, VA 24482 - Phone
- (540) 248-0424
- NPI assigned
- Oct 30, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 27, 2016 through Jan 27, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401410527 | VA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401410527 | VA | Yes |
Addresses
Primary practice location
56 Quicks Mill Rd
Verona, VA 24482
Mailing address
614 S Poplar Ave
Waynesboro, VA 22980
Phone (540) 248-0424
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0016649 | Medicaid | VA |
Other providers in Verona, VA
- Lilith Higgins
- Aaron Horton
- Ivyrehab Sept, LLC
- Ashley Sorrells Jenkins
- Sarah Jones
- Karen Lee Klotz
- Koinonia, Inc
- Michael J Kosta
- Daniel Braddock La Grua
- Dale Labrecque
All providers in Verona, VA · General Practice Dentistry in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.