Individual provider Active NPI

Theron M Jones, DMD

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1770544876
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
013061 Issued in GA
Practice address
5819 Campbellton Rd SW
Suite 103
Atlanta, GA 30331-8046
Phone
(706) 627-3054
Fax
(404) 349-8058
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 21478 MA
General Practice Dentistry 1223G0001X 013061 GA Primary
General Practice Dentistry 1223G0001X 8338 TN

Addresses

Primary practice location

5819 Campbellton Rd SW
Suite 103
Atlanta, GA 30331-8046

Mailing address

5819 Campbellton Rd SW
Suite 103
Atlanta, GA 30331-8046
Phone (706) 627-3054

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

LicenseStateTypeSpecialty
013061GAMDGeneral Practice Dentistry
21478MAMDPhysical Therapist
8338TNMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371513600000",
    "number": "1770544876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5819 CAMPBELLTON RD SW",
            "address_2": "SUITE 103",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318046",
            "telephone_number": "706-627-3054",
            "fax_number": "404-349-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5819 CAMPBELLTON RD SW",
            "address_2": "SUITE 103",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318046",
            "telephone_number": "706-627-3054",
            "fax_number": "404-349-8058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "THERON",
        "middle_name": "M",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2013-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21478",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "013061",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "8338",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.