Provider Demographics
NPI:1780675132
Name:JONES, ARONDA R (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARONDA
Middle Name:R
Last Name:JONES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11726 ST CHARLES ROCK ROAD
Mailing Address - Street 2:SUITE L
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044
Mailing Address - Country:US
Mailing Address - Phone:314-209-7770
Mailing Address - Fax:314-209-7772
Practice Address - Street 1:11726 ST CHARLES ROCK ROAD
Practice Address - Street 2:SUITE L
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044
Practice Address - Country:US
Practice Address - Phone:314-209-7770
Practice Address - Fax:314-209-7772
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0161041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO404633117Medicaid