Joel Steven Reynolds, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

08991 Issued in IA

Practice address

1469 29TH St
West Des Moines, IA 50266-1302

Phone

(515) 223-6529

Fax

(515) 223-5448

NPI assigned

May 5, 2009

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

Enrolled in IA

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

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372464000000",
    "number": "1346474376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 JORDAN GRV",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502657691",
            "telephone_number": "515-229-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1469 29TH ST",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661302",
            "telephone_number": "515-223-6529",
            "fax_number": "515-223-5448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JOEL",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-05",
        "last_updated": "2013-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IA",
            "license": "08991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revision Therapy PLLC
• Revitalize LLC
• Jessica D Reyes
• Kimberly Reyes
• Ramon Santiago Reyes, M.D.
• Randal David Reynolds, PH.D.
• Steven Thomas Reynolds, DDS,MS
• Susan Rhyan, PA-C
• Heather Renee Rice, CADC
• Justin Chad Rice, MD

• Oral and Maxillofacial Surgery (Dentist) in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2013; 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.