Heather Lee Reynolds, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

102 W Progress Dr
Princeton, IL 61356-8601

Phone

(815) 875-1138

NPI assigned

Feb 1, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346388535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 CORNELL ST",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613503824",
            "telephone_number": "815-245-4875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W PROGRESS DR",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613568601",
            "telephone_number": "815-875-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "HEATHER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Rebholz
• Kolton Reeverts, DPT
• Angela Reidner, RN, MS, CNM
• Residential Alternatives of Illinois Inc (Hawthorne Inn of Princeton)
• Residential Alternatives of Illinois Inc (Manor Court of Princeton)
• Rebekka J Root, FNP
• Robin L Rose, APRN, FNP-BC
• Petrita Laverne Salazar, LCPC
• Miles Todd Salsman, C.R.N.A.
• Diane Schaffer-Vandenborre

• General Practice Dentistry in Princeton, IL
• Providers in Princeton, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.