Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | DEN1001599 | DC |
Y | 1223G0001X | General Practice | DEN1001599 | DC |
Y | 213EG0000X | General Practice | DEN1001599 | DC |
NPI | 1316307986 |
---|---|
Provider Name | Elise Jones |
First Address | Washington, DC 20020-4913 |
Second Address | Washington, DC 20020-4913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2016 |
Last Update Date | 03/11/2016 |