Provider Demographics
NPI:1184387086
Name:JONES, MARIA ANDREINA (DDS, MS)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ANDREINA
Last Name:JONES
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 S INDIANA AVE APT 6506
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3359
Mailing Address - Country:US
Mailing Address - Phone:310-497-9739
Mailing Address - Fax:
Practice Address - Street 1:851 W BELMONT AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4401
Practice Address - Country:US
Practice Address - Phone:773-985-4819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.032937122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist