Individual provider Active NPI

Shelly Fay Jones, D.D.S.

  • General Practice Dentistry
  • Midland, MI
National Provider Identifier
1710080528
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901017333 Issued in MI
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, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 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 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

IdentifierTypeStateIssuer
1710080528MedicaidMI

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150929002590 MI Order and Referring Only - DentistPractitioner - Dentist 8729396403

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901017333MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.