Michael Douglas Reardon, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8689 Issued in TN

Practice address

2315 Hickory Valley Rd
Chattanooga, TN 37421-1723

Phone

(423) 894-1029

NPI assigned

Jul 19, 2007

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

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.

• Oral Sleep Solutions

  • Durable Medical Equipment & Medical Supplies
  • Chattanooga, TN
  • NPI 1063108587
  NPD (past)

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184803200000",
    "number": "1427258409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 HICKORY VALLEY RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211723",
            "telephone_number": "423-894-1029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 HICKORY VALLEY RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211723",
            "telephone_number": "423-894-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REARDON",
        "first_name": "MICHAEL",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-19",
        "last_updated": "2007-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "8689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Allen Raymer
• Raymond Group Inc
• Rciv, LLC
• Laura Ashworth Reagan, MS, RD,CDE
• Tiffaney Renee Reagan, R.N.
• Justin Eugene Reason, APRN
• Zoe Smalley Reasons, MD
• Lauren Elizabeth Reaves, BCBA. LBA
• Luanne Reavley, RDH
• Rebound LLC

• General Practice Dentistry in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; 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.