Jesse Akers Reagin, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN17530 Issued in FL

Practice address

1737 North Clyde Morris Blvd
Suite 150
Daytona Beach, FL 32117

Phone

(386) 274-1450

NPI assigned

Apr 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1881811461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SHADY BRANCH TRL",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321744930",
            "telephone_number": "386-589-2081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1737 NORTH CLYDE MORRIS BLVD",
            "address_2": "SUITE 150",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32117",
            "telephone_number": "386-274-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAGIN",
        "first_name": "JESSE",
        "middle_name": "AKERS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Clark Raval, RPH.
• William Ravizza
• Larissa A Raymond
• Glenn Hidalgo Rayos, MD
• Denise Ann Read, DO48699
• Recovering Futures Inc.
• Robert Nolan Reed, LMHC
• Ryan R Rees, M.D.
• William Andrew Reese, MD
• Marilyn L Regis, MD

• General Practice Dentistry in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.