Healthcare Provider Details

I. General information

NPI: 1245344845
Provider Name (Legal Business Name): GLADIS C JONES RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 BLUE PKWY
KANSAS CITY MO
64130-2807
US

IV. Provider business mailing address

7913 E 120TH ST
GRANDVIEW MO
64030-1330
US

V. Phone/Fax

Practice location:
  • Phone: 816-923-5800
  • Fax: 913-448-2909
Mailing address:
  • Phone: 816-214-6027
  • Fax: 816-448-2909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: