William Roneu Reagan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9109 Issued in TX

Practice address

444 Forest SQ
Longview, TX 75605-4463

Phone

(903) 758-4431

Fax

(903) 753-5458

NPI assigned

Mar 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1649303397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 FOREST SQ",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756054463",
            "telephone_number": "903-758-4431",
            "fax_number": "903-753-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 FOREST SQ",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756054463",
            "telephone_number": "903-758-4431",
            "fax_number": "903-753-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAGAN",
        "first_name": "WILLIAM",
        "middle_name": "RONEU",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "9109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIP PROVIDER #",
            "identifier": "B09109-1",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENCE #",
            "identifier": "9109",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aatif Rashid, MD
• Kaye Butler Ratzlaff, LPC
• Fred Dee Rea, D.D.S.
• Karen Frazer Rea, D.D.S.
• Kimberly Diane Reagan, LPC
• Real Jobs for You, Inc.
• Rebound Pain Management & Rehabilitation, LLC
• John Michael Red Fox
• Rekha Reddy, M.D.
• Sanjay G Reddy, M.D; M.P.H

• General Practice Dentistry in Longview, TX
• Providers in Longview, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.