Michael Reynolds, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D9172 Issued in OR

Practice address

2952 Lazy Creek Dr
Medford, OR 97504-8182

Phone

(888) 468-0022

Fax

(541) 504-3907

NPI assigned

Sep 15, 2008

Last updated

Oct 3, 2011By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

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.

• Advantage Dental Clinics, LLC

  • General Practice Dentistry
  • Redmond, OR
  • NPI 1992935357
  NPD (past)

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1629227681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977560092",
            "telephone_number": "888-468-0022",
            "fax_number": "541-504-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2952 LAZY CREEK DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048182",
            "telephone_number": "888-468-0022",
            "fax_number": "541-504-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-15",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "246610",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maliah Reyes
• Yuliana Reyes
• Lydia Reymer
• Adrienne Reynolds
• Ariana Keyasha Reynolds
• Susan Reynolds, PT
• Yue Reynolds, FNP
• Brian Rheault, SLP
• Leslie Ingrid Rheault, MA, LPC
• Amanda Rhein, LMT

• Dentist in Medford, OR
• Providers in Medford, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.