Healthcare Provider Details

I. General information

NPI: 1629950613
Provider Name (Legal Business Name): REEVES COSMETIC DENTISTRY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8040 HUGH DANIEL DR
HOOVER AL
35242-7102
US

IV. Provider business mailing address

9012 EAGLE VALLEY LN
BIRMINGHAM AL
35242-6992
US

V. Phone/Fax

Practice location:
  • Phone: 205-991-9997
  • Fax: 205-991-9925
Mailing address:
  • Phone: 205-999-1938
  • Fax: 205-991-9925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JUSTIN TODD REEVES
Title or Position: PROVIDER
Credential: DMD
Phone: 205-991-9997