Individual provider Active NPI

Eric Michael Reed, D.D.S.

  • Dentist
  • Lakewood, CA
National Provider Identifier
1790807121
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
CA 39324 Issued in CA
Practice address
2704 Del Amo Blvd
Lakewood, CA 90712-2902
Phone
(562) 423-1441
Fax
(562) 423-1442
NPI assigned
Apr 5, 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
Dentist 122300000X CA 39324 CA Primary

Addresses

Primary practice location

2704 Del Amo Blvd
Lakewood, CA 90712-2902

Mailing address

2704 Del Amo Blvd
Lakewood, CA 90712-2902
Phone (562) 423-1441

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
CA 39324CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ganji & Ganji DDS Corporation PastSince Nov 12, 2023 Accepting new patients

Organizations & group practices 1

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": "1175731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790807121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 DEL AMO BLVD",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907122902",
            "telephone_number": "562-423-1441",
            "fax_number": "562-423-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 DEL AMO BLVD",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907122902",
            "telephone_number": "562-423-1441",
            "fax_number": "562-423-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED",
        "first_name": "ERIC",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "CA 39324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.