Individual provider Active NPI

Michael A Jones, DDS

  • General Practice Dentistry
  • Kailua Kona, HI
National Provider Identifier
1780730416
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DT-977 Issued in HI
Practice address
75-1028 Henry St. Ste 203
Kailua Kona, HI 96740
Phone
(808) 329-4425
Fax
(808) 329-0872
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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 DT-977 HI Primary

Addresses

Primary practice location

75-1028 Henry St. Ste 203
Kailua Kona, HI 96740

Mailing address

75-1028 Henry St #203
Crossroads Medical Center
Kailua Kona, HI 96740
Phone (808) 329-4425

Other identifiers 1

IdentifierTypeStateIssuer
16677358MedicaidCO

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DT-977HIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1780730416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-1028 HENRY ST #203",
            "address_2": "CROSSROADS MEDICAL CENTER",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "96740",
            "telephone_number": "808-329-4425",
            "fax_number": "808-329-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-1028 HENRY ST. STE 203",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "96740",
            "telephone_number": "808-329-4425",
            "fax_number": "808-329-0872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT-977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16677358",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.