Provider Demographics
NPI:1427506724
Name:STONE, JARRETT SHANE (DDS)
Entity type:Individual
Prefix:DR
First Name:JARRETT
Middle Name:SHANE
Last Name:STONE
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 1:141 NW RENFRO ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-4183
Mailing Address - Country:US
Mailing Address - Phone:817-295-6141
Mailing Address - Fax:
Practice Address - Street 1:6617 PRECINCT LINE RD STE 100
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-4389
Practice Address - Country:US
Practice Address - Phone:972-921-1615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-14
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32393122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist