Provider Demographics
NPI:1942452768
Name:JONES, KRISTA MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:MARIE
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 1:2000 E 15TH ST
Mailing Address - Street 2:BLDG. 200
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-6697
Mailing Address - Country:US
Mailing Address - Phone:405-341-0203
Mailing Address - Fax:405-341-9370
Practice Address - Street 1:2000 E 15TH ST
Practice Address - Street 2:BLDG. 200
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-6697
Practice Address - Country:US
Practice Address - Phone:405-341-0203
Practice Address - Fax:405-341-9370
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-13
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4252122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist