Terry Justin Reavis, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4843 Issued in OK

Practice address

13302 S Memorial Dr
Bixby, OK 74008-3114

Phone

(918) 369-3990

Fax

(918) 369-8505

NPI assigned

Mar 23, 2006

Last updated

Jun 23, 2008By 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 1

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bixby Family Dentistry PLLC

  • General Practice Dentistry
  • Bixby, OK
  • NPI 1730389669
  NPD (past) Authorized official
• Bixby Dental Group, PLLC

  • Dentist
  • Bixby, OK
  • NPI 1356808935
  NPD (past)

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1548220650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13302 S MEMORIAL DR",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "740083114",
            "telephone_number": "918-369-3990",
            "fax_number": "918-369-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13302 S MEMORIAL DR",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "740083114",
            "telephone_number": "918-369-3990",
            "fax_number": "918-369-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAVIS",
        "first_name": "TERRY",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "4843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prophylaxis Healthcare LLC (Axis HealthCare)
• Prophylaxis Primary Care and Behavioral Healthcare Services Inc
• Eliana Provenzano-Lewis
• Rapid Care, Inc.
• Jeff Ravenscroft
• Laura Reibenstein, PHARMD
• Amelia Danielle Rice
• Riverstone Medical LLC
• Paige Lauren Rogers, DO
• Cathy Ross, MS CCC-SLP

• General Practice Dentistry in Bixby, OK
• Providers in Bixby, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.