Reaves Dental Practice, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

053015 Issued in NY

Legal business name

REAVES DENTAL PRACTICE, PLLC

Practice address

4301 Middle Settlement Rd
New Hartford, NY 13413-5317

Phone

(315) 736-0139

Fax

(315) 768-6148

NPI assigned

Dec 31, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Justin J Reaves, DDS

Title

Owner - General Dentist

Phone

(315) 736-0139

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Glenn Ashley Reaves, D.D.S.

  • Dentist
  • New Hartford, NY
  • NPI 1376542399
  Medicare reassignment

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

{
    "created_epoch": "1230681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415145600000",
    "number": "1124264866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 MIDDLE SETTLEMENT RD",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134135317",
            "telephone_number": "315-736-0139",
            "fax_number": "315-768-6148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 MIDDLE SETTLEMENT RD",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134135317",
            "telephone_number": "315-736-0139",
            "fax_number": "315-768-6148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REAVES DENTAL PRACTICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-31",
        "last_updated": "2014-11-05",
        "status": "A",
        "authorized_official_last_name": "REAVES",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER - GENERAL DENTIST",
        "authorized_official_telephone_number": "315-736-0139",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "032955",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "053015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dayal Davis Raja, M.D.
• Richard Wilton Raney, PH.D.
• Aymen Rashid
• Francesca C Raymond, RPH
• Sultana Razia, M.D.
• Glenn Ashley Reaves, D.D.S.
• Justin John Reaves, D.D.S.
• Michael Reddy, PA
• Michael Wayne Redner, D.O.
• Floyd Richard Reginelli, RPH

• Dental Clinic/Center in New Hartford, NY
• Providers in New Hartford, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.