Individual provider Active NPI

Ryan Matthew Reeves, DDS

  • General Practice Dentistry
  • Savannah, GA
National Provider Identifier
1629119466
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN015037 Issued in GA
Practice address
1317 Abercorn St
Savannah, GA 31401-6939
Phone
(912) 234-8282
NPI assigned
Feb 12, 2007
Last updated
Jan 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN015037 GA Primary
General Practice Dentistry 1223G0001X 0401411477 VA

Addresses

Primary practice location

1317 Abercorn St
Savannah, GA 31401-6939

Mailing address

1317 Abercorn St
Savannah, GA 31401-6939
Phone (912) 234-8282

Other practice location 1

29 Plantation Park Dr Ste 301
Bluffton, SC 29910-9007
Phone (843) 706-2999

Other identifiers 2

IdentifierTypeStateIssuer
54-1030707OtherVAFEDERAL TAX ID
781417OtherVAUNITED CONCORDIA PROVIDER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20150505000895 VA Order and Referring Only - DentistPractitioner - Dentist 3476872938

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN015037GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bradford a. Durham DMD, PC General Practice 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, 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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1629119466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 ABERCORN ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314016939",
            "telephone_number": "912-234-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 ABERCORN ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314016939",
            "telephone_number": "912-234-8282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29 Plantation Park Dr Ste 301",
            "address_purpose": "LOCATION",
            "city": "Bluffton",
            "state": "SC",
            "postal_code": "299109007",
            "country_code": "US",
            "telephone_number": "843-706-2999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REEVES",
        "first_name": "RYAN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015037",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411477",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "54-1030707",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "781417",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.