Individual provider Active NPI

Scott M Redlinger, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Reno, NV
National Provider Identifier
1588878342
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
S2-124 Issued in NV
Practice address
5420 Kietzke LN Ste 102
Reno, NV 89511-2063
Phone
(775) 853-9696
NPI assigned
May 10, 2007
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6721 NE
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 12345678 NE
Oral and Maxillofacial Surgery (Dentist) 1223S0112X S2-124 NV Primary

Addresses

Primary practice location

5420 Kietzke LN Ste 102
Reno, NV 89511-2063

Mailing address

5420 Kietzke LN Ste 102
Reno, NV 89511-2063
Phone (775) 853-9696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141114000732 NV Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6305068958

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12345678NEMDOral and Maxillofacial Surgery (Dentist)
6721NEMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reno Oral & Maxillofacial Surgery Oral and Maxillofacial Surgery PastSince Nov 17, 2024 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1588878342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 KIETZKE LN STE 102",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112063",
            "telephone_number": "775-853-9696",
            "fax_number": "775-853-9695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 KIETZKE LN STE 102",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112063",
            "telephone_number": "775-853-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDLINGER",
        "first_name": "SCOTT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "6721",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NE",
            "license": "12345678",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NV",
            "license": "S2-124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.