Provider Demographics
NPI:1376610055
Name:KRISTA M. JONES DDS PC
Entity Type:Organization
Organization Name:KRISTA M. JONES DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-341-0203
Mailing Address - Street 1:2000 E 15TH ST
Mailing Address - Street 2:BLDG. 200
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-6697
Mailing Address - Country:US
Mailing Address - Phone:405-341-0203
Mailing Address - Fax:405-341-9370
Practice Address - Street 1:2000 E 15TH ST
Practice Address - Street 2:BLDG. 200
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-6697
Practice Address - Country:US
Practice Address - Phone:405-341-0203
Practice Address - Fax:405-341-9370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty