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NPI Code Detail

MEDICARE: TISHA R JONES DDS

MEDICARE: TISHA R JONES DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist2002012027MO

General Provider Information

NPI Number : 1396839189
Entity Type Code : Individual
Provider Name (Legal Business Name) : TISHA R JONES DDS
Provider Business Mailing Address
First Line : 1916 N BALTIMORE ST
Second Line :
City : KIRKSVILLE
State : MO
Zip : 63501-1902
Country : US
Telephone Number : 660-665-1901
Fax Number : 660-665-1903
Provider Business Practice Location Address
First Line : 1916 N BALTIMORE ST
Second Line :
City : KIRKSVILLE
State : MO
Zip : 63501-1902
Country : US
Telephone Number : 660-665-1901
Fax Number : 660-665-1903
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 11/12/2025

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Directions to “ TISHA R JONES DDS” Practice Location

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