Individual provider Active NPI

Jay M Jones, DDS

  • Dentist
  • Anoka, MN
National Provider Identifier
1033488499
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D12687 Issued in MN
Practice address
736 E River Rd
Anoka, MN 55303-2828
Phone
(763) 421-4140
Fax
(763) 421-5737
NPI assigned
Dec 14, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D12687 MN Primary

Addresses

Primary practice location

736 E River Rd
Anoka, MN 55303-2828

Mailing address

736 E River Rd
Anoka, MN 55303-2828
Phone (763) 421-4140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150608001903 MN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7517288186

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D12687MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jones Family Dentistry LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1033488499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 E RIVER RD",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553032828",
            "telephone_number": "763-421-4140",
            "fax_number": "763-421-5737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 E RIVER RD",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553032828",
            "telephone_number": "763-421-4140",
            "fax_number": "763-421-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "JAY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-14",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anoka, MN

Sources for this page

Verify at the official NPI Registry.