Individual provider Active NPI

David P Reichwage, DDS

  • Dentist
  • Fort Wayne, IN
National Provider Identifier
1578733713
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6980 Issued in IN
Practice address
2031 Reed Rd
Fort Wayne, IN 46815-7311
Phone
(260) 426-1086
NPI assigned
Mar 4, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6980 IN Primary

Addresses

Primary practice location

2031 Reed Rd
Fort Wayne, IN 46815-7311

Mailing address

2031 Reed Rd
Fort Wayne, IN 46815-7311
Phone (260) 426-1086

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
6980INMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Wayne Smiles PC Dentist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1578733713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 REED RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468157311",
            "telephone_number": "260-426-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 REED RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468157311",
            "telephone_number": "260-426-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICHWAGE",
        "first_name": "DAVID",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "6980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.