Provider Demographics
NPI:1295022564
Name:JONES, ANNA R (DDS)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:R
Last Name:JONES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:R
Other - Last Name:BOONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2911 SOUTH BELT HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:ST. JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64503-1587
Mailing Address - Country:US
Mailing Address - Phone:816-364-6444
Mailing Address - Fax:816-364-6929
Practice Address - Street 1:2911 SOUTH BELT HIGHWAY
Practice Address - Street 2:
Practice Address - City:ST. JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64503-1587
Practice Address - Country:US
Practice Address - Phone:816-364-6444
Practice Address - Fax:816-364-6929
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011014512122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1295022564Medicaid