Brandon William Reddinger, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

6883-15 Issued in WI

Practice address

512 N Young St
Kennewick, WA 99336-7839

Phone

(509) 783-7600

NPI assigned

Apr 3, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 28, 2018 through Mar 28, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1134485154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 N YOUNG ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367839",
            "telephone_number": "509-783-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 N YOUNG ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367839",
            "telephone_number": "509-783-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDINGER",
        "first_name": "BRANDON",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-03",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6883-15",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE60595962",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurel Reagan, LMP
• Eryn Reager, DO
• Lisa Marie Reardon, PA-C
• Rebecca'S Uptown Design
• Lynn Michelle Reberger
• Amy Lynn Redmond, BSW
• Hayley M Redmond
• Elaine Redner
• Sheila D Rege, MD
• Gary L Reiber, MD

• Dentist in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.