Kelly A Reynolds, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2154 Issued in MT

Practice address

515 North Broadway
Suite 4
Red Lodge, MT 59068-9255

Phone

(406) 446-2814

NPI assigned

Jun 11, 2008

Last updated

Nov 7, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

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

Medicare enrollment (NPD)

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.

• Rubicon Dental Associates PLLC

  • General Practice Dentistry
  • Billings, MT
  • NPI 1215357397
  NPD (past)

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510012800000",
    "number": "1811157183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 AVANTA WAY",
            "address_2": "SUITE 3",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591026873",
            "telephone_number": "406-702-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 NORTH BROADWAY",
            "address_2": "SUITE 4",
            "city": "RED LODGE",
            "state": "MT",
            "postal_code": "590689255",
            "telephone_number": "406-446-2814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "KELLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2017-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MT",
            "license": "2154",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "2154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Red Lodge Drug Co Inc
• Red Lodge Public Schools
• Red Lodge Public Schools
• Red Lodge Rural Fire District 7
• Redbarn Counseling and Consultation
• Mark Eric Robertson, PT
• SCL Health Medical Group - Billings LLC (Red Lodge Clinic - Family Medicine)
• Rebecca Anne Sharar
• Danielle Marie Sindelar, RD
• Walter James Smith, MA, LCPC, NCC

• General Practice Dentistry in Red Lodge, MT
• Providers in Red Lodge, MT by specialty
• General Practice Dentistry in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.