Dustin Shane Reynolds, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

0401413169 Issued in VA

Practice address

2904 Old Forest Rd
Lynchburg, VA 24501-2320

Phone

(434) 664-7039

NPI assigned

Jun 27, 2011

Sex

Male

Sole proprietor

No

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

Enrolled in VA

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 and National Provider Directory roles.

• Dustin S. Reynolds, D.D.S., P.C.

  • Dental Clinic/Center
  • Lynchburg, VA
  • NPI 1841685864
  NPD (past) Authorized official

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1306132485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2904 OLD FOREST RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012320",
            "telephone_number": "434-439-4942",
            "fax_number": "434-439-4936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2904 OLD FOREST RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012320",
            "telephone_number": "434-664-7039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "DUSTIN",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-27",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413169",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "3941",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revely Transports LLC
• Monica Revely
• Revine Care LLC
• Revive Health Services, LLC
• Caroline Reynolds, D.O.
• Andrew Rheam
• Rheumatology of Central Virginia Family Physicians, Inc.
• Rice Counseling & Associates, Inc
• Jessica R Rice, CCC-SLP
• Mary E. Rice, LPC

• Dentist in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; 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.