Juan Reid, DDS
Individual provider Active NPI Dentist · Columbus, GA
NPI 1154422657 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1154422657
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 8540 (GA)
- Practice address
- 2018 Auburn Ave
Columbus, GA 31906-1708 - Phone
- (706) 568-6501
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8540 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affordable Dentures - Columbus LL. P.C. | Dentist | Past | Accepting new patients |
| Affordable Dentures-Columbus II,P.C. | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8540 | GA | Yes |
Addresses
Primary practice location
2018 Auburn Ave
Columbus, GA 31906-1708
Mailing address
2018 Auburn Ave
Columbus, GA 31906-1708
Other providers in Columbus, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.