Provider Demographics
NPI:1841370335
Name:JONES, SHELBY REID (DDS)
Entity type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:REID
Last Name:JONES
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 1:2209 W I 240 SERVICE RD
Mailing Address - Street 2:STE 315
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-8249
Mailing Address - Country:US
Mailing Address - Phone:405-688-2500
Mailing Address - Fax:405-688-2504
Practice Address - Street 1:2209 W I 240 SERVICE RD
Practice Address - Street 2:STE 315
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-8249
Practice Address - Country:US
Practice Address - Phone:405-688-2500
Practice Address - Fax:405-688-2504
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK55291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice