Magnon Ivan Reyes, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

053114 Issued in NY

Practice address

3753 91St St
Jackson Heights, NY 11372-7901

Phone

(646) 306-7141

NPI assigned

Oct 12, 2006

Last updated

Apr 1, 2015By the provider in NPPES

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 NY

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Magnon Reyes DDS PLLC

  dba Coney Island Dental Arts

  • Dentist
  • Brooklyn, NY
  • NPI 1215562491
  NPD (past) Authorized official

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427846400000",
    "number": "1356430706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 OLD PALISADE RD",
            "address_2": "APT 1102",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070247064",
            "telephone_number": "646-306-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3753 91ST ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727901",
            "telephone_number": "646-306-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "MAGNON",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2015-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "053114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reliable Home Care Serices Corp.
• Elyse Michelle Rella, LMSW
• Michelle Ariana Rendon
• Rest Medical Care PC
• Reyes Ny LLC (Farmacia America)
• Xiomara Reyes, LMSW
• Patria Iris Reynoso, DDS
• Jai J Rhee
• Seung Hea Rhee, PHARM.D
• Richard P. Medina, DDS, LLC

• Oral and Maxillofacial Surgery (Dentist) in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; 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.