Jake Reynolds, DMD, MSD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

9015 Issued in NC

Practice address

610 Dr. Calvin Jones Hwy
Suite 100
Wake Forest, NC 27587

Phone

(919) 336-5230

Fax

(919) 336-5231

NPI assigned

Nov 9, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• K. Kevin Neshat, DDS, MD, PA

  • Endodontics
  • Wake Forest, NC
  • NPI 1265117725
  NPD (past)

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420156800000",
    "number": "1225019979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 DR. CALVIN JONES HWY",
            "address_2": "SUITE 100",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "27587",
            "telephone_number": "919-336-5230",
            "fax_number": "919-336-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 DR. CALVIN JONES HWY",
            "address_2": "SUITE 100",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "27587",
            "telephone_number": "919-336-5230",
            "fax_number": "919-336-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JAKE",
        "name_prefix": "Dr.",
        "credential": "DMD, MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2015-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NC",
            "license": "9015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Relational Behavioral Health PLLC
• Renewing Paths Counseling Services, PLLC
• Catherine Restrepo, MS, CCC-SLP
• Retina Institute of North Carolina, PC
• Jennifer Revoir, LCSW
• Jessica H Reynolds, DPT
• Riccobene & Associates I, DDS, P.a.
• Ashley Rice, DPT
• Angela Richardson, LPCA
• Luann F Richardson, PNP

• Endodontics in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Endodontics in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2015; 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.