Reed Creek Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

REED CREEK DENTAL LLC

Practice address

4213 Columbia Rd
Martinez, GA 30907-1481

Phone

(706) 868-6177

NPI assigned

Dec 13, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Blake Taylor Ross, DMDNPI 1225761828

Title

Owner

Phone

(705) 868-6177

Specialties & licenses 1

Addresses

Other names 1

• Reed Creek Dental Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Blake Taylor Ross, DMD

  • General Practice Dentistry
  • Evans, GA
  • NPI 1225761828
  NPD Authorized official
• Jenni Olson, DMD

  • Student in an Organized Health Care Education/Training Program
  • Farmington, CT
  • NPI 1609515899
  NPD
• David Earl Reid, D.D.S.

  • General Practice Dentistry
  • Martinez, GA
  • NPI 1184643793
  NPD (past)

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1841901592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4213 COLUMBIA RD",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309071481",
            "telephone_number": "706-868-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4213 COLUMBIA RD",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309071481",
            "telephone_number": "706-868-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REED CREEK DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-13",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "705-868-6177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reed Creek Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sandra Kay Rabil, LPN
• Lewis Allen Raborn Jr.
• Nicolette Ramirez
• Randy Georgemiller, PH.D., P.C.
• Monique Rauls
• Venna Reese, HEALTH PROFESSION
• David Earl Reid, D.D.S.
• William Alexander Reid, MD
• Elizabeth Graham Reiter, LAPC
• Release Restore Redefine Counseling LLC

• General Practice Dentistry in Martinez, GA
• Providers in Martinez, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.

Verify at the official NPI Registry.