Maura Bridgett Reynolds, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

2596 Issued in RI

Practice address

1145 Reservoir Ave
Suite 225
Cranston, RI 02920-6055

Phone

(401) 943-7714

Fax

(401) 946-3780

NPI assigned

Apr 17, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in RI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ocean State Endodontics

  • Endodontics
  • Cranston, RI
  • NPI 1275694218
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285850453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 LENIHAN LANE",
            "city": "EAST GREENWICH",
            "state": "RI",
            "postal_code": "02818",
            "telephone_number": "401-398-1144",
            "fax_number": "401-946-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 RESERVOIR AVE",
            "address_2": "SUITE 225",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029206055",
            "telephone_number": "401-943-7714",
            "fax_number": "401-946-3780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MAURA",
        "middle_name": "BRIDGETT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "RI",
            "license": "2596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jorge Luis Resendiz, MSN, APRN-CNP, FNP-C
• Reservoir Dental LLC (Reservoir Dental)
• Reservoir Family Dental, LLC
• Restore Physical Therapy, LLC
• Dakota Reyes
• Rhode Island Center for Balance Disorders, LLC
• Rhode Island Counseling and Hypnotherapy Center Inc
• Rhode Island Counseling Associates LLC
• Rhode Island CVS Pharmacy LLC (CVS Pharmacy # 05868)
• Rhode Island CVS Pharmacy, L.L.C. (CVS Pharmacy # 00469)

• Endodontics in Cranston, RI
• Providers in Cranston, RI by specialty
• Endodontics in Rhode Island

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.