Mary Catherine Reynolds, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

4065-19 Issued in MS

Practice address

106 Central Blvd
Flora, MS 39071-8003

Phone

(601) 879-0031

NPI assigned

Jun 5, 2019

Last updated

Jun 5, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

State licenses

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1659939585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 CAMBRIDGE DR",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108975",
            "telephone_number": "601-466-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 CENTRAL BLVD",
            "city": "FLORA",
            "state": "MS",
            "postal_code": "390718003",
            "telephone_number": "601-879-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MARY",
        "middle_name": "CATHERINE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "4065-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oliver Instrument Company
• Optical 2000 of Flora PA
• Julie Ann Orr, LPC
• Nicholas Parsa
• Quad Intermed Company LLC (MEA Medical Clinics)
• River Oaks Management Company, LLC (Flora Family Physicians)
• Caitlin Sisco
• The Corner Pharmacy and Market
• Latanya Renae Thompson
• Tiny Talkers LLC

• Dentist in Flora, MS
• Providers in Flora, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; 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.