Provider Demographics
NPI:1295846806
Name:JONES, D KEITH (DDS)
Entity Type:Individual
Prefix:DR
First Name:D
Middle Name:KEITH
Last Name:JONES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:647 COUNTRY CLUB TER
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-2450
Mailing Address - Country:US
Mailing Address - Phone:785-841-0233
Mailing Address - Fax:785-841-0255
Practice Address - Street 1:647 COUNTRY CLUB TER
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-2450
Practice Address - Country:US
Practice Address - Phone:785-841-0233
Practice Address - Fax:785-841-0255
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS57801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice