Dr. Reynolds Cosmetic Dental Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019017700 Issued in IL

Legal business name

DR. REYNOLDS COSMETIC DENTAL CENTER

Practice address

101 Madison St
Suite 301
Oak Park, IL 60302-4278

Phone

(708) 383-0500

Fax

(708) 383-0800

NPI assigned

Jan 6, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Pamela Reynolds, D.D.S.NPI 1699974279

Title

Dentist/President

Phone

(708) 383-0500

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Pamela Jean Reynolds, D.D.S.

  • General Practice Dentistry
  • Oak Park, IL
  • NPI 1699974279
  NPD (past) Authorized official

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325808000000",
    "number": "1992075972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2216",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603032216",
            "telephone_number": "708-383-0500",
            "fax_number": "708-383-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MADISON ST",
            "address_2": "SUITE 301",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603024278",
            "telephone_number": "708-383-0500",
            "fax_number": "708-383-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. REYNOLDS COSMETIC DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-06",
        "last_updated": "2012-01-06",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "708-383-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019017700",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028628",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Oak Park, IL
• Providers in Oak Park, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2012; 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.