Donald Smith Redford, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS003845 Issued in TN

Practice address

350 Blountville Hwy
Suite 204
Bristol, TN 37620-0213

Phone

(423) 968-4114

Fax

(423) 968-4294

NPI assigned

Mar 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1972563468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 BLOUNTVILLE HWY",
            "address_2": "SUITE 204",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376200213",
            "telephone_number": "423-968-4114",
            "fax_number": "423-968-4294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BLOUNTVILLE HWY",
            "address_2": "SUITE 204",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376200213",
            "telephone_number": "423-968-4114",
            "fax_number": "423-968-4294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDFORD",
        "first_name": "DONALD",
        "middle_name": "SMITH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS003845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3224945",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8019894",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Jo Ratliff, D.M.D.
• Kelsee Rawson, BCABA
• Mary Barbara Raykowitz, LPC
• Ready Set Grow Pediatric Therapy LLC
• Scottie Reagan II, DDS
• Annette Sandra Reece, LBA, BCBA
• Renaissance Surgery Center, LLC
• Michael Wayne Rentz, MD
• Inger L Reynolds, CRNA
• Robert David Reynolds Jr., APRN

• Oral and Maxillofacial Surgery (Dentist) in Bristol, TN
• Providers in Bristol, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.