Individual provider Active NPI

Robert Timothy Reeves, D.D.S.

  • General Practice Dentistry
  • Ft Worth, TX
National Provider Identifier
1700935673
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16737 Issued in TX
Practice address
3116 Handley Dr
Ft Worth, TX 76112-7013
Phone
(817) 457-3116
Fax
(817) 457-3119
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 16737 TX Primary

Addresses

Primary practice location

3116 Handley Dr
Ft Worth, TX 76112-7013

Mailing address

3116 Handley Dr
Ft Worth, TX 76112-7013
Phone (817) 457-3116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20150901001189 TX Order and Referring Only - DentistPractitioner - Dentist 8820304181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16737TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700935673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 HANDLEY DR",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761127013",
            "telephone_number": "817-457-3116",
            "fax_number": "817-457-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3116 HANDLEY DR",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761127013",
            "telephone_number": "817-457-3116",
            "fax_number": "817-457-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEVES",
        "first_name": "ROBERT",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Worth, TX

Sources for this page

Verify at the official NPI Registry.