Bradley G Reynolds, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

4980 Issued in AL

Practice address

114 E Brookwood Road
Midfield, AL 35228

Phone

(205) 923-6828

Fax

(205) 923-1680

NPI assigned

Nov 24, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Midfield Dental Center Associates

  • Oral and Maxillofacial Surgery (Dentist)
  • Midfield, AL
  • NPI 1558436485
  NPD (past)

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093880924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 PALEO PL",
            "city": "INDIAN SPRINGS",
            "state": "AL",
            "postal_code": "351243724",
            "telephone_number": "205-995-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E BROOKWOOD ROAD",
            "city": "MIDFIELD",
            "state": "AL",
            "postal_code": "35228",
            "telephone_number": "205-923-6828",
            "fax_number": "205-923-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "BRADLEY",
        "middle_name": "G",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "4980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "51504362REY",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Nichols, DMD
• Nna of Alabama, Inc. (RCG Midfield)
• Danielle Outlaw, DDS
• Naga Pannala, M.D.
• Shavatey Powell
• Willamena Rambo Richardson, RN
• Secure Transporation
• Christopher Todd Shuemaker
• Luke Robert Taylor, DDS
• Vital Smiles Alabama

• Dentist in Midfield, AL
• Providers in Midfield, AL by specialty
• Dentist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.