Individual provider Active NPI

Louis Reisman Jr., D.M.D.

  • General Practice Dentistry
  • Savannah, GA
National Provider Identifier
1326158643
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN010240 Issued in GA
Practice address
2515 Habersham St
Savannah, GA 31401-9346
Phone
(912) 234-2206
Fax
(912) 238-1522
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN010240 GA Primary

Addresses

Primary practice location

2515 Habersham St
Savannah, GA 31401-9346

Mailing address

PO Box 14546
Savannah, GA 31416-1546
Phone (912) 234-2206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20150709002092 GA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9436461050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN010240GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Habersham Dental of Savannah LLC General Practice Past Accepting new patients
Habersham Dental Partners, LLC General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1326158643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14546",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314161546",
            "telephone_number": "912-234-2206",
            "fax_number": "912-238-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 HABERSHAM ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314019346",
            "telephone_number": "912-234-2206",
            "fax_number": "912-238-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISMAN",
        "first_name": "LOUIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN010240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.