Jeffrey Damon Reitzel, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN1855919 Issued in MA

Practice address

200 5TH Ave
3Rd Floor
Waltham, MA 02451-8779

Phone

(781) 647-0772

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404604800000",
    "number": "1871682906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 5TH AVE",
            "address_2": "3RD FLOOR",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024518779",
            "telephone_number": "781-647-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 5TH AVE",
            "address_2": "3RD FLOOR",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024518779",
            "telephone_number": "781-647-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REITZEL",
        "first_name": "JEFFREY",
        "middle_name": "DAMON",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2014-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "4214",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "DN1855919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX4214",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Philip R Reilly, M.D.
• Sarah Ann Reilly, LCSW
• Shelley Reimer, D.C.
• Ellen Reiner, PH.D.
• Michael M. Reinold, PT
• Relate, LLC
• Remtech Healthcare Staffing LTD
• Cassandra D Remy, PHARM.D
• Retirementjobs.Com, Inc.
• Martha Claire Reuman Pieper, NP

• Oral and Maxillofacial Surgery (Dentist) in Waltham, MA
• Providers in Waltham, MA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2014; 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.