Active NPI
Breanne Williams Reid, DDS
- Dentist
- San Diego, CA
National Provider Identifier
1710026059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 57698
- Practice address
- 8733 Tillage Lane
San Diego, CA 92127 - Phone
- (858) 997-7444
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 57698 | CA | Primary |
| Dentist | 122300000X | DS036911 | PA |
Addresses
Primary practice location
8733 Tillage Lane
San Diego, CA 92127
Mailing address
8733 Tillage Lane
San Diego, CA 92127
Phone (858) 997-7444
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
| License | State | Type | Specialty |
|---|---|---|---|
| DS036911 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658275200000",
"number": "1710026059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8733 TILLAGE LANE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92127",
"telephone_number": "858-997-7444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8733 TILLAGE LANE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92127",
"telephone_number": "858-997-7444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REID",
"first_name": "BREANNE",
"middle_name": "WILLIAMS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2022-07-20",
"certification_date": "2022-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "57698",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS036911",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.