Royce Willard Reese Sr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12230 Issued in TX

Practice address

8525 Boat Club Rd
Reese Dental at Lake Country, PLLC
Fort Worth, TX 76179

Phone

(817) 500-5288

Fax

(817) 500-5288

NPI assigned

Nov 29, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Reese Dental at Lake Country, PLLC

  • General Practice Dentistry
  • Fort Worth, TX
  • NPI 1487010591
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1003983073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8525 BOAT CLUB RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76179",
            "telephone_number": "817-500-5288",
            "fax_number": "817-500-5288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8525 BOAT CLUB RD",
            "address_2": "REESE DENTAL AT LAKE COUNTRY, PLLC",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76179",
            "telephone_number": "817-500-5288",
            "fax_number": "817-500-5288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "ROYCE",
        "middle_name": "WILLARD",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "12230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Reese, LPC
• Alexis Nicole Reese
• Daniel Reese, LCSW
• Linda Atlas Reese, D.O.
• Noah D Reese, CRNA
• Sherry A Reese, FNP
• William G Reese, MD
• David L Reeve, M.D.
• Nancy W Reeve, RN, WHCNP
• Andrea Grace Reeves

• General Practice Dentistry in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.