Individual provider Active NPI

John Mark Reichley, DMD

  • Dentist
  • Virginia Beach, VA
National Provider Identifier
1487807574
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
04014113226 Issued in VA
Practice address
2100 Lynnhaven Pkwy
Virginia Beach, VA 23456-1492
Phone
(215) 896-0406
NPI assigned
Nov 3, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 04014113226 VA Primary

Addresses

Primary practice location

2100 Lynnhaven Pkwy
Virginia Beach, VA 23456-1492

Mailing address

2100 Lynnhaven Pkwy
Virginia Beach, VA 23456-1492
Phone (215) 896-0406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
04014113226VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1487807574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 LYNNHAVEN PKWY",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234561492",
            "telephone_number": "215-896-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 LYNNHAVEN PKWY",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234561492",
            "telephone_number": "215-896-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICHLEY",
        "first_name": "JOHN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-03",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "04014113226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.