Individual provider Active NPI

Joan Mary Reick, D.D.S.

  • Dentist
  • Birmingham, AL
National Provider Identifier
1669627436
Registry record updated Nov 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
AL.- 3695 Issued in AL
Practice address
705 Crested Fern LN
Birmingham, AL 35244-1494
Phone
(205) 985-0400
Fax
(205) 985-0401
NPI assigned
Nov 20, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X AL.- 3695 AL Primary

Addresses

Primary practice location

705 Crested Fern LN
Birmingham, AL 35244-1494

Mailing address

705 Crested Fern LN
Birmingham, AL 35244-1494
Phone (205) 985-0400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AL.- 3695ALMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1227139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227139200000",
    "number": "1669627436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 CRESTED FERN LN",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352441494",
            "telephone_number": "205-985-0400",
            "fax_number": "205-985-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 CRESTED FERN LN",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352441494",
            "telephone_number": "205-985-0400",
            "fax_number": "205-985-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICK",
        "first_name": "JOAN",
        "middle_name": "MARY",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-20",
        "last_updated": "2008-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "AL.- 3695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; 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.