Individual provider Active NPI

David Lee Jones, DDS

  • General Practice Dentistry
  • Council Bluffs, IA
National Provider Identifier
1366417016
Registry record updated Jul 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
08132 Issued in IA
Practice address
1026 Woodbury Ave
Suite 30
Council Bluffs, IA 51503-7915
Phone
(712) 328-8573
Fax
(712) 328-0233
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 08132 IA Primary

Addresses

Primary practice location

1026 Woodbury Ave
Suite 30
Council Bluffs, IA 51503-7915

Mailing address

1026 Woodbury Ave
Council Bluffs, IA 51503-7915
Phone (712) 328-8573

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20150609001756 IA Order and Referring Only - DentistPractitioner - Dentist 1850612326

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08132IAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469750400000",
    "number": "1366417016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 WOODBURY AVE",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515037915",
            "telephone_number": "712-328-8573",
            "fax_number": "712-328-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 WOODBURY AVE",
            "address_2": "SUITE 30",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515037915",
            "telephone_number": "712-328-8573",
            "fax_number": "712-328-0233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "DAVID",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2016-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.