Provider Demographics
NPI:1821381914
Name:FOX, JARED STEPHENS (DDS)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:STEPHENS
Last Name:FOX
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 1:2300 SW 29TH ST
Mailing Address - Street 2:SUITE 223
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66611-1887
Mailing Address - Country:US
Mailing Address - Phone:785-267-6120
Mailing Address - Fax:785-267-6928
Practice Address - Street 1:2300 SW 29TH ST
Practice Address - Street 2:SUITE 223
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-1887
Practice Address - Country:US
Practice Address - Phone:785-267-6120
Practice Address - Fax:785-267-6928
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-23
Last Update Date:2014-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS607961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice