Randy Reasch, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4431 Issued in AZ

Practice address

2121 West Reservation Loop Road
Camp Verde, AZ 86322-8412

Phone

(928) 567-2168

NPI assigned

Jan 29, 2007

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 TX

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)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1134265275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-0698",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911100698",
            "telephone_number": "602-263-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 WEST RESERVATION LOOP ROAD",
            "city": "CAMP VERDE",
            "state": "AZ",
            "postal_code": "863228412",
            "telephone_number": "928-567-2168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1185 N Arizona Blvd",
            "address_purpose": "LOCATION",
            "city": "Coolidge",
            "state": "AZ",
            "postal_code": "852283203",
            "country_code": "US",
            "telephone_number": "520-723-3801",
            "fax_number": "520-723-8207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REASCH",
        "first_name": "RANDY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "4431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153875",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Elizabeth Packard
• Ronald Eugene Parfitt, MD
• Eric Pettersen, D.M.D.
• Rainbow Acres
• Rayburn Chiropractic Clinic, P.C.
• Recovery Innovations of Arizona, Inc
• Shannon Rhoda
• Darlene Kay Richey
• Ronald E. Parfitt, M.D., PC
• Sherri Ruggiero, PHD

• General Practice Dentistry in Camp Verde, AZ
• Providers in Camp Verde, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.