Active NPI
Shelly Fay Jones, D.D.S.
- General Practice Dentistry
- Midland, MI
National Provider Identifier
1710080528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2901017333
- Practice address
- 6118 Merlin CT
Midland, MI 48640-7358 - Phone
- (989) 835-5665
- Fax
- (989) 835-5656
- NPI assigned
- Sep 7, 2006
- Last updated
- May 19, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901017333 | MI | Primary |
Addresses
Primary practice location
6118 Merlin CT
Midland, MI 48640-7358
Mailing address
2401 N Trail Rd
Midland, MI 48642-8841
Phone (989) 430-2816
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710080528 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150929002590 | MI | Order and Referring Only - Dentist | 8729396403 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901017333 | MI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jones and Jones, DDS, PC | General Practice | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Midland, MI
- NPI 1588060727
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463616000000",
"number": "1710080528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 N TRAIL RD",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486428841",
"telephone_number": "989-430-2816",
"fax_number": "989-835-5656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6118 MERLIN CT",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486407358",
"telephone_number": "989-835-5665",
"fax_number": "989-835-5656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "SHELLY",
"middle_name": "FAY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-07",
"last_updated": "2016-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901017333",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1710080528",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Midland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.