Renaissance Dental & Surgical Arts, Inc.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

RENAISSANCE DENTAL & SURGICAL ARTS, INC.

Practice address

3707 N Canyon Rd Ste 2a
Provo, UT 84604-4525

Phone

(951) 294-7230

NPI assigned

Feb 14, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Gino Antonio Reynoso, DDSNPI 1013750397

Title

Owner/Periodontist

Phone

(951) 294-7230

Specialties & licenses 1

Addresses

Practitioners 1

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

• Gino Antonio Reynoso, DDS

  • Periodontics
  • Upland, CA
  • NPI 1013750397
  NPD Authorized official

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

{
    "created_epoch": "1739491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739491200000",
    "number": "1851196968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 N 900 E",
            "city": "SALEM",
            "state": "UT",
            "postal_code": "846535541",
            "telephone_number": "951-294-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 N CANYON RD STE 2A",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846044525",
            "telephone_number": "951-294-7230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE DENTAL & SURGICAL ARTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-14",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A",
        "authorized_official_last_name": "REYNOSO",
        "authorized_official_first_name": "GINO",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "OWNER/PERIODONTIST",
        "authorized_official_telephone_number": "951-294-7230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patty J Reid, RN
• Sheralyn Kay Lubean Reid
• Cristy Reinoso
• Emma Remington, ATC, LAT
• Madeline Alexis Remkes
• Lauren Olson Rencher, SSW
• Lyndsey Rencher
• Susan Rene' Renelle, R.N.
• Renick Therapy, PLLC
• Andrew James Renick, LCSW

• Periodontics in Provo, UT
• Providers in Provo, UT by specialty
• Periodontics in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; 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.