Dr. Tom JONES
ID #136
🏥 Practice Information
Practice Name:
Miami dental
Doctor Name:
Dr. Tom JONES
Phone:
234-654-6353
Email:
David314@matchmydentist.com
Address:
123 main 01601
Zipcode:
01601
Joined Platform:
06/07/2025
📊 Performance Metrics
Total Matches:
0 patients
Completed Appts:
0
Patient No-Shows:
0
Patients Refused:
0
Cancelled by Pt:
0
Total Earnings:
$0.00 (0 × $399)
Account Status:
❌ Inactive
📋 Detailed Information
Recent Patient Matches
Original Questionnaire Responses
Q: Office Email
A: office4@matchmydentist.com

Q: Practice Name
A: miami dental

Q: Address
A: 123 main

Q: City
A: miami

Q: State
A: fl

Q: Zip Code
A: 33009

Q: Office Phone
A: 2131231232

Q: First Name
A: tom

Q: Last Name
A: JONES

Q: Degree
A: DDS

Q: Area of Practice
A: Specialist

Q: Experience
A: 0-5 years

Q: Languages Spoken
A: English

Q: How many new patients are you looking for monthly?
A: 6-15 new patients

Q: Ready to Start Receiving Matches?
A: Yes, I want to start as soon as my profile is approved

Q: URL
A: https://WWW.MATCHMYDENTIST.COM

Q: Has your license to practice in this state or any other state been denied, restricted, limited, suspended or revoked; have you ever been reprimanded by a state licensing agency; or are any of these actions pending with respect to your license?
A: No

Q: Has your DEA Registration ever been restricted, limited, suspended or revoked, or are any of these actions pending with respect to your DEA Registration?
A: No

Q: Have your hospital privileges, if any, ever been revoked, suspended, reduced, or not renewed; have disciplinary proceedings ever been instituted against you; or are any of these actions now pending with respect to your hospital privileges?
A: No

Q: Do you now have or have you had a chemical dependency/substance abuse problem?
A: No

Q: Malpractice Document
A: View Document

Q: DEA Certificate
A: View Document

Q: State Dental License
A: View Document

Q: Only the doctor may complete and certify this form. Are you the doctor personally completing this form?
A: Yes

Q: By clicking "I accept" below, you agree to the above certification terms and conditions and consent to electronic signature
A: Yes

Payment History
Doctor Timeline
Date Joined:
06/07/2025
Complaints/Notes
📝 Admin Notes