Paul Duane Reznicek, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

014865 Issued in MO

Practice address

1400 State RT F
Waynesville, MO 65583

Phone

(573) 774-6101

Fax

(573) 774-6812

NPI assigned

Nov 8, 2011

Sex

Male

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 1, 2015 through Jun 1, 2027

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.

• Reznicek Dental Group LLC

  • General Practice Dentistry
  • Waynesville, MO
  • NPI 1063447860
  NPD (past) Authorized official

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1326325192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 STATE RT F",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "65583",
            "telephone_number": "573-774-6101",
            "fax_number": "573-774-6812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 STATE RT F",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "65583",
            "telephone_number": "573-774-6101",
            "fax_number": "573-774-6812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZNICEK",
        "first_name": "PAUL",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-08",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "014865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Rapier
• Tonya R Rawlings, PLPC
• Addison James Reiser, LMT
• Joseph William Reynolds IV, LMSW
• Reznicek Dental Group LLC
• Christina Richards
• Richland Medical Center, Inc.
• Roots of Healing Counseling LLC
• RPCS, Inc
• Clifton Junior Ruggs III, D.MIN., LPC, CASAC

• Dentist in Waynesville, MO
• Providers in Waynesville, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.