Individual provider Active NPI

Matthew McReynolds, D.D.S.

  • Dentist
  • Oklahoma City, OK
National Provider Identifier
1083065874
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6855 Issued in OK
Practice address
8283 S Walker Ave
#A
Oklahoma City, OK 73139-9413
Phone
(405) 632-5561
NPI assigned
Jun 23, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6855 OK Primary

Addresses

Primary practice location

8283 S Walker Ave
#A
Oklahoma City, OK 73139-9413

Mailing address

8283 S Walker Ave
#A
Oklahoma City, OK 73139-9413
Phone (405) 632-5561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6855OKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Dental Past Accepting new patients
Matthew D. McReynolds, D.D.S, P.L.L.C. Dentist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1083065874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8283 S WALKER AVE",
            "address_2": "#A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399413",
            "telephone_number": "405-632-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8283 S WALKER AVE",
            "address_2": "#A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399413",
            "telephone_number": "405-632-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCREYNOLDS",
        "first_name": "MATTHEW",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-23",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.