Active NPI
Thomas Alan Reese, DMD
- Dentist
- Shiprock, NM
National Provider Identifier
1932196276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS025922L
- Practice address
- US Hwy 491 North
Shiprock, NM 87420 - Phone
- (505) 368-6401
- Fax
- (505) 368-6431
- NPI assigned
- Oct 3, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS025922L | PA | Primary |
Addresses
Primary practice location
US Hwy 491 North
Shiprock, NM 87420
Mailing address
PO Box 160
Shiprock, NM 87420-0160
Phone (505) 368-6401
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 703753 | Medicaid | AZ | |
| R5287 | Medicaid | NM | |
| 99056551 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS025922L | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190246400000",
"number": "1932196276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 160",
"city": "SHIPROCK",
"state": "NM",
"postal_code": "874200160",
"telephone_number": "505-368-6401",
"fax_number": "505-368-6431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "US HWY 491 NORTH",
"city": "SHIPROCK",
"state": "NM",
"postal_code": "87420",
"telephone_number": "505-368-6401",
"fax_number": "505-368-6431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REESE",
"first_name": "THOMAS",
"middle_name": "ALAN",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-03",
"last_updated": "2007-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS025922L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "703753",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "R5287",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "99056551",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shiprock, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.