Individual provider Active NPI

Reyna Guadalupe Garcia, DDS

  • Dentist
  • Milwaukee, WI
National Provider Identifier
1760830228
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1001340 Issued in WI
Practice address
3522 W Lisbon Ave
Milwaukee, WI 53208
Phone
(414) 935-8000
Fax
(414) 935-8011
NPI assigned
May 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1001340 WI Primary

Addresses

Primary practice location

3522 W Lisbon Ave
Milwaukee, WI 53208

Mailing address

PO Box 80257
Milwaukee, WI 53208-8004
Phone (414) 935-8000

Other identifiers 2

IdentifierTypeStateIssuer
13836184OtherCAQH
1760830228OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20180301000429 WI Practitioner - Dentist 0042502833 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1001340WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Community Health Centers, Inc. Dentist CurrentSince Jan 30, 2018 Accepting new patients
True Dental LLC Dentist Past Accepting new patients

Locations

3522 W Lisbon Ave
Milwaukee, WI 53208
Phone (414) 935-8000

Interoperability endpoints

  • Direct secure messaging: rgarcia224580@direct.ochin.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1760830228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80257",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532088004",
            "telephone_number": "414-935-8000",
            "fax_number": "414-344-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3522 W LISBON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53208",
            "telephone_number": "414-935-8000",
            "fax_number": "414-935-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "REYNA",
        "middle_name": "GUADALUPE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-25",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13836184",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1760830228",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.