Provider Demographics
NPI:1053705517
Name:JONES, MELANIE VENTOCILLA (DDS)
Entity type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:VENTOCILLA
Last Name:JONES
Suffix:
Gender:
Credentials:DDS
Other - Prefix:DR
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:VENTOCILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:4029 ELLICOTT ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-1011
Mailing Address - Country:US
Mailing Address - Phone:571-220-9164
Mailing Address - Fax:
Practice Address - Street 1:6303 LITTLE RIVER TPKE STE 160
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-5045
Practice Address - Country:US
Practice Address - Phone:703-942-8404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-23
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401414660122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentistGroup - Single Specialty