Reynolds Dental Clinic P.a.

Primary specialty

DentistTaxonomy code 122300000X

License

20159 Issued in TX

Legal business name

REYNOLDS DENTAL CLINIC P.A.

Practice address

6242 Rufe Snow Dr
Suite 220
Fort Worth, TX 76148-3340

Phone

(817) 656-4656

NPI assigned

Sep 14, 2010

Organization subpart

No

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

Authorized official

Name

Dr. CHI T Le, D.D.S.

Title

Owner

Phone

(817) 656-4656

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329264000000",
    "number": "1295043107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6242 RUFE SNOW DR",
            "address_2": "SUITE 220",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761483340",
            "telephone_number": "817-656-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6242 RUFE SNOW DR",
            "address_2": "SUITE 220",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761483340",
            "telephone_number": "817-656-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REYNOLDS DENTAL CLINIC P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-14",
        "last_updated": "2012-02-15",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "CHI",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-656-4656",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "20159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152674102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205029601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roxanna Yvette Reyes
• Victoria Reyes
• Liliana Reyna
• Miranda Teresa Reyna, PT, DPT
• Meagan Reyneveld
• Barbara Louise Reynolds-Brown, M.ED. , LPC-S, NBBC
• Elissa Reynolds-Chavez
• Amanda Paige Reynolds
• Ashley Susanne Reynolds, FNP-C
• Chandra N Reynolds, MD

• Dentist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.