Joseph N Reardon, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

6273-015 Issued in WI

Practice address

200 Mercy Circle
Oceanside, CA 92055

Phone

(760) 763-1122

NPI assigned

Aug 6, 2008

Last updated

Sep 26, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1427214709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MERCY CIRCLE",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "760-763-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MERCY CIRCLE",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "760-763-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REARDON",
        "first_name": "JOSEPH",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-06",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6273-015",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "6273-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anuja S Raste, MS
• Nikhilkumar Raval, M.D.
• Dennis Pansacola Raymundo, SFIDC
• Nicole Kirsten Raymundo, R.N.
• Ashley Nicole Fredeluces Rayos
• Rebuild Therapy Services LLC (Rebuild Therapy Services)
• Tina L Recalde, D.P.T.
• Julia Recht, MOT, OTR/L
• Barry Stephen Reder, DDS
• Jacob L Redmon

• Oral and Maxillofacial Surgery (Dentist) in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.