NPIMap

Organization Active NPI

Michael L. Reznik, D.D.S., M.S., Inc

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Odessa, TX
National Provider Identifier
1336365253
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
11123 Issued in TX
Legal business name
MICHAEL L. REZNIK, D.D.S., M.S., INC
Practice address
2469 E 11TH St
Odessa, TX 79761-4232
Phone
(432) 333-7105
Fax
(432) 333-9490
NPI assigned
Apr 18, 2007
Last updated
Jun 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

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

Authorized official

Name
Dr. Michael Louis Reznik, D.D.S.NPI 1174523799
Title
President
Phone
(432) 333-7105

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 11123 TX Primary

Addresses

Primary practice location

2469 E 11TH St
Odessa, TX 79761-4232

Mailing address

2469 E 11TH St
Odessa, TX 79761-4232
Phone (432) 333-7105

National Provider Directory

National Provider Directory

Locations

2469 E 11th St
Odessa, TX 79761
Phone (432) 333-7105

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1336365253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2469 E 11TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614232",
            "telephone_number": "432-333-7105",
            "fax_number": "432-333-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2469 E 11TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614232",
            "telephone_number": "432-333-7105",
            "fax_number": "432-333-9490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL L. REZNIK, D.D.S., M.S., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "REZNIK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "432-333-7105",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "11123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.