Audra Buckley Reynoso, D.M.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN1856601 Issued in MA

Practice address

100 Amesbury St
Suite 110
Lawrence, MA 01840-1321

Phone

(978) 686-3838

NPI assigned

Jun 10, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Audra Leah Buckley Former name

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.

• DRS Giordano and Lem PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lawrence, MA
  • NPI 1144243544
  NPD (past)
• Merrimack Valley Orthodontics LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lawrence, MA
  • NPI 1184075038
  NPD (past)

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1235542903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 E 4TH ST",
            "address_2": "UNIT 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021273242",
            "telephone_number": "781-258-5127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 AMESBURY ST",
            "address_2": "SUITE 110",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018401321",
            "telephone_number": "978-686-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOSO",
        "first_name": "AUDRA",
        "middle_name": "BUCKLEY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "DN1856601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDRA",
            "last_name": "BUCKLEY",
            "middle_name": "LEAH",
            "credential": "D.M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marlene Reyes
• Miladys Reyes, LPN
• Stephanie Reyes
• Jennifer Reynolds, LMHC
• Michelle Donohue Reynolds, MSW INTERN
• Maria Reynoso
• Williany Reynoso
• Laura Anne Rheault, APRN
• Ann Marie Rheaume, LPN
• Rhina R Houston Licsw LLC

• Orthodontics and Dentofacial Orthopedics Dentistry in Lawrence, MA
• Providers in Lawrence, MA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; 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.