Merritt Elmer Jones, DDS

Individual provider Active NPI General Practice Dentistry · Jesup, IA

NPI 1699840652 · NPPES record last updated Mar 7, 2023

Key facts

NPI
1699840652
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
1A6567 (IA)
Practice address
551 Young Street
Jesup, IA 50648
Phone
(319) 827-1401
Fax
(319) 827-1401
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160408001640 IA Order and Referring Only - Dentist
Practitioner - Dentist
3577861475

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1A6567IAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1A6567 IA Yes

Addresses

Primary practice location

551 Young Street
Jesup, IA 50648

Mailing address

PO Box 563
551 Young Street
Jesup, IA 50648
Phone (319) 827-1401

Other identifiers

IdentifierTypeStateIssuer
1A6567OtherIA1BDE LICENSE #

Other providers in Jesup, IA

All providers in Jesup, IA · General Practice Dentistry in Iowa

Sources for this page

Verify at the official NPI Registry.