Active NPI
William Russell McReynolds, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Louisville, MS
National Provider Identifier
1356423404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 3237-02
- Practice address
- 401 E Main St
Louisville, MS 39339-2707 - Phone
- (662) 773-6215
- Fax
- (662) 773-6217
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 3237-02 | MS | Primary |
Addresses
Primary practice location
401 E Main St
Louisville, MS 39339-2707
Mailing address
401 E Main St
Louisville, MS 39339-2707
Phone (662) 773-6215
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08907831 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3237-02 | MS | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355184000000",
"number": "1356423404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 E MAIN ST",
"city": "LOUISVILLE",
"state": "MS",
"postal_code": "393392707",
"telephone_number": "662-773-6215",
"fax_number": "662-773-6217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 E MAIN ST",
"city": "LOUISVILLE",
"state": "MS",
"postal_code": "393392707",
"telephone_number": "662-773-6215",
"fax_number": "662-773-6217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCREYNOLDS",
"first_name": "WILLIAM",
"middle_name": "RUSSELL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2012-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MS",
"license": "3237-02",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "08907831",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.