Jose B De Los Reyes, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

300 North Milwaukee Avenue
Suite a
Lake Villa, IL 60046

Phone

(847) 699-2358

Fax

(847) 265-0744

NPI assigned

Feb 6, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jose B De Los Reyes Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• De Los Reyes Dental LTD.

  • General Practice Dentistry
  • Lake Villa, IL
  • NPI 1245463371
  NPD (past)

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1376721985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "address_2": "300 NORTH MILWAUKEE AVENUE SUITE A",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "60046",
            "telephone_number": "847-699-2358",
            "fax_number": "847-265-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NORTH MILWAUKEE AVENUE",
            "address_2": "SUITE A",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "60046",
            "telephone_number": "847-699-2358",
            "fax_number": "847-265-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LOS REYES",
        "first_name": "JOSE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSE",
            "last_name": "DE LOS REYES",
            "middle_name": "B",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mark J Clauser, RBT
• Sandra Ellen Johnson Clavelli, PSY.D.
• Ricky Joseph Colmer, PHD, LAC.
• Diana Cuna
• De Los Reyes Dental LTD.
• Kristine Sue Decant, DPT, NCS
• Jigisha Desai, PHARM D
• Jacklyn Louise Durnil, M.S., CCC-SLP
• Kelly Nichole Eckhart, APRN
• Anna Michelle Edmiston, M.D.

• General Practice Dentistry in Lake Villa, IL
• Providers in Lake Villa, 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 Feb 6, 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.