Reo Family Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12011855A Issued in IN

Legal business name

REO FAMILY DENTAL

Practice address

3430 W State Road 66
Rockport, IN 47635-9259

Phone

(812) 649-4416

Fax

(812) 649-2651

NPI assigned

Oct 12, 2016

Last updated

Oct 13, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brittany Eirwin-Maqueda, DMDNPI 1841555463

Title

Owner Dentist

Phone

(812) 649-4416

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brittany Carol Eirwin-Maqueda, DMD

  • General Practice Dentistry
  • Rockport, IN
  • NPI 1841555463
  NPD (past) Authorized official
• Arnold H Braun, DDS

  • Dentist
  • Rockport, IN
  • NPI 1609952050
  NPD (past)

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476316800000",
    "number": "1417407644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 W STATE ROAD 66",
            "city": "ROCKPORT",
            "state": "IN",
            "postal_code": "476359259",
            "telephone_number": "812-649-4416",
            "fax_number": "812-649-2651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 W STATE ROAD 66",
            "city": "ROCKPORT",
            "state": "IN",
            "postal_code": "476359259",
            "telephone_number": "812-649-4416",
            "fax_number": "812-649-2651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REO FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-13",
        "status": "A",
        "authorized_official_last_name": "EIRWIN-MAQUEDA",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "812-649-4416",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011855A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201115460",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeanne Ann Powers, PHARMACY TECH. CPHT
• Procare Healthspot, LLC
• Prorehab Inc
• Rapha Healthcare
• Rebecca Hunt Counseling LLC
• Riverview Surgery Center LLC
• Rockport Ohio Township Fire Department
• David Roos, ATC
• Glenn Alan Sherman, D.O
• South Spencer County School Corporation

• General Practice Dentistry in Rockport, IN
• Providers in Rockport, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; 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.