Provider Demographics
NPI:1093928509
Name:SMJ DENTAL ASSOCIATES LTD
Entity Type:Organization
Organization Name:SMJ DENTAL ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:MEIGS
Authorized Official - Last Name:JONES
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-262-2992
Mailing Address - Street 1:1901 WEST 47TH PLACE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-1834
Mailing Address - Country:US
Mailing Address - Phone:913-262-2992
Mailing Address - Fax:913-262-3205
Practice Address - Street 1:1901 WEST 47TH PLACE
Practice Address - Street 2:SUITE 101
Practice Address - City:WESTWOOD
Practice Address - State:KS
Practice Address - Zip Code:66205-1834
Practice Address - Country:US
Practice Address - Phone:913-262-2992
Practice Address - Fax:913-262-3205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6519122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty