Individual provider Active NPI

Bruce Daniel Reish, DDS

  • General Practice Dentistry
  • Stroudsburg, PA
National Provider Identifier
1164408324
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS017831L Issued in PA
Practice address
RR 7 Box 7311
Stroudsburg, PA 18360-8748
Phone
(570) 424-6607
Fax
(570) 424-0466
NPI assigned
Dec 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS017831L PA Primary

Addresses

Primary practice location

RR 7 Box 7311
Stroudsburg, PA 18360-8748

Mailing address

RR 7 Box 7311
Stroudsburg, PA 18360-8748
Phone (570) 424-6607

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164408324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 7 BOX 7311",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183608748",
            "telephone_number": "570-424-6607",
            "fax_number": "570-424-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 7 BOX 7311",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183608748",
            "telephone_number": "570-424-6607",
            "fax_number": "570-424-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISH",
        "first_name": "BRUCE",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS017831L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.