Reginald Douglas Booker, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013464 Issued in GA

Practice address

4005 Winder Hwy
#100
Flowery Branch, GA 30542-6564

Phone

(770) 531-3232

NPI assigned

Jun 21, 2006

Last updated

Mar 31, 2014By 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

Other names 1

• Dr. Reginald Booker Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Royal Lakes Family and Cosmetic Dentistry, LLC

  • General Practice Dentistry
  • Flowery Branch, GA
  • NPI 1710216783
  NPD (past) Authorized official

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396224000000",
    "number": "1699711416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 WINDER HWY",
            "address_2": "STE. 110",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305426564",
            "telephone_number": "770-531-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 WINDER HWY",
            "address_2": "#100",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305426564",
            "telephone_number": "770-531-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOKER",
        "first_name": "REGINALD",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2014-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "813355373A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REGINALD",
            "last_name": "BOOKER",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brendon Blake, P.T.
• Gina Renee Blake, P.T.
• Eric L Bohn, M.D.
• Trevor Bond, DPT
• Booker Oral Surgery & Implant Center PC
• Karon Bradley
• Rebecca Braselton, RPH
• Benjamin Braza
• Christopher Jonathan Leigh Brookes, D.C.
• Catherine Elizabeth Brown, PHARMD

• General Practice Dentistry in Flowery Branch, GA
• Providers in Flowery Branch, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2014; 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.