Provider Demographics
NPI:1699840652
Name:JONES, MERRITT ELMER (DDS)
Entity Type:Individual
Prefix:DR
First Name:MERRITT
Middle Name:ELMER
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:PO BOX 563
Mailing Address - Street 2:551 YOUNG STREET
Mailing Address - City:JESUP
Mailing Address - State:IA
Mailing Address - Zip Code:50648
Mailing Address - Country:US
Mailing Address - Phone:319-827-1401
Mailing Address - Fax:319-827-1401
Practice Address - Street 1:551 YOUNG STREET
Practice Address - Street 2:
Practice Address - City:JESUP
Practice Address - State:IA
Practice Address - Zip Code:50648
Practice Address - Country:US
Practice Address - Phone:319-827-1401
Practice Address - Fax:319-827-1401
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1A65671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1A6567Other1BDE LICENSE #
IAAJ9434426OtherDEA #
IA0176990Medicare ID - Type Unspecified