Reavley Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

REAVLEY DENTAL

Practice address

804 Gulf Street
Lamar, MO 64759-6475

Phone

(417) 682-3393

Fax

(417) 682-6659

NPI assigned

Dec 13, 2021

Last updated

Dec 21, 2021By 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

Ms. Carol D Reavley

Title

Office Manager

Phone

(417) 682-3393

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640044800000",
    "number": "1447919840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 GULF STREET",
            "city": "LAMAR",
            "state": "MO",
            "postal_code": "64759",
            "telephone_number": "417-682-3393",
            "fax_number": "417-683-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 GULF STREET",
            "city": "LAMAR",
            "state": "MO",
            "postal_code": "647596475",
            "telephone_number": "417-682-3393",
            "fax_number": "417-682-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REAVLEY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A",
        "authorized_official_last_name": "REAVLEY",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "417-682-3393",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eden Christine Ogden, RN
• Ozark Tri-County Health Care Consortium (ACCESS Family Care)
• Ozark Tri-County Health Care Consortium (Access Family Care)
• Ozark Tri-County Health Care Consortium (Access Family Care)
• Jimmy Wayne Pyron, DO
• Brian A Reavley, DDS
• Regional Services (Coxhealth School Based Telemedicine)
• Bethany Rice, COTA/L
• Richard R. Behrend, Inc
• Jessica Robertson, PHARMD

• Dental Clinic/Center in Lamar, MO
• Providers in Lamar, MO by specialty
• Dental Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.