Active NPI
Robert Simon Jones, DDS PHD
- Dentist
- Minneapolis, MN
National Provider Identifier
1093047771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- FF44
- Practice address
- 515 Delaware Street SE
6-150 Moos Health Sciences
Minneapolis, MN 55455 - Phone
- (612) 625-0395
- Fax
- (612) 626-2900
- NPI assigned
- Feb 5, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | FF44 | MN | Primary |
| Dentist | 122300000X | 51481 | CA |
Addresses
Primary practice location
515 Delaware Street SE
6-150 Moos Health Sciences
Minneapolis, MN 55455
Mailing address
515 Delaware Street SE
6-150 Moos Health Sciences
Minneapolis, MN 55455
Phone (612) 625-0395
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51481 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265328000000",
"number": "1093047771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 DELAWARE STREET SE",
"address_2": "6-150 MOOS HEALTH SCIENCES",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55455",
"telephone_number": "612-625-0395",
"fax_number": "612-626-2900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 DELAWARE STREET SE",
"address_2": "6-150 MOOS HEALTH SCIENCES",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55455",
"telephone_number": "612-625-0395",
"fax_number": "612-626-2900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "ROBERT",
"middle_name": "SIMON",
"name_prefix": "Dr.",
"credential": "DDS PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-02-05",
"last_updated": "2010-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "FF44",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "51481",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.