David L Reagan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

32166 Issued in CA

Practice address

11401 Heacock St
Suite 320
Moreno Valley, CA 92557-7908

Phone

(951) 247-7040

Fax

(951) 247-5092

NPI assigned

Aug 1, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. David L Reagan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• David Reagan & Robert Smith DDS Smith Robert F Gen PTR.

  • General Practice Dentistry
  • Moreno Valley, CA
  • NPI 1669540084
  NPD (past) Authorized official

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

{
    "created_epoch": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217548800000",
    "number": "1467618199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11401 HEACOCK ST",
            "address_2": "SUITE 320",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925577908",
            "telephone_number": "951-247-7040",
            "fax_number": "951-247-5092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11401 HEACOCK ST",
            "address_2": "SUITE 320",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925577908",
            "telephone_number": "951-247-7040",
            "fax_number": "951-247-5092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAGAN",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-01",
        "last_updated": "2008-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "32166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL",
            "identifier": "G90361-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "REAGAN",
            "middle_name": "L",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rose Rayfiled, CADC II
• Frances Raymond
• Brittany Chante Geraldine Raynor, DO
• Ana Rayo, LMFT
• Maria L Reabroi, PHARM.D.
• Susan R Real-Raz, DMD
• Realtime Transportation 4 You LLC
• Marielle Reataza, M.D.
• Julio Rebollar
• Guadalupe Recio Garcia

• Dentist in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.