Bryan D Reeder

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D011608 Issued in AZ

Practice address

7890 E Florentine Rd
Prescott Valley, AZ 86314-1204

Phone

(928) 642-9051

NPI assigned

Jun 21, 2019

Sex

Male

Sole proprietor

Yes

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

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.

• Bryan Reeder DMD PLLC

  • Dental Clinic/Center
  • Prescott, AZ
  • NPI 1376349902
  NPD Authorized official
• Stephenville Dental, PLLC

  • General Practice Dentistry
  • Stephenville, TX
  • NPI 1548643786
  NPD (past)

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667692800000",
    "number": "1285295279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7890 E FLORENTINE RD",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141204",
            "telephone_number": "928-642-9051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7890 E FLORENTINE RD",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141204",
            "telephone_number": "928-642-9051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Wolfe Nursery Rd Ste 180",
            "address_purpose": "LOCATION",
            "city": "Stephenville",
            "state": "TX",
            "postal_code": "764013767",
            "country_code": "US",
            "telephone_number": "254-965-1931",
            "fax_number": "254-965-1933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REEDER",
        "first_name": "BRYAN",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-21",
        "last_updated": "2022-11-06",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "35226",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randi Morris FNP, PLLC
• Melissa Rauch, MA, LAC
• Autumn Re
• Charles F Reed, D.D.S., M.S.
• Sean C Reed, D.D.S.
• Reflections Recovery Detox, LLC
• Refuge Rehab LLC
• Kara Regehr, PA-C
• Catherine N Reid-McKee, NP
• Miriam Berenice Rendon Zavala, PTA

• General Practice Dentistry in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2022; 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.