Healthcare Provider Details

I. General information

NPI: 1508028036
Provider Name (Legal Business Name): EVAN J REED D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10401 CLAYTON RD STE 150
FRONTENAC MO
63131-2909
US

IV. Provider business mailing address

10401 CLAYTON RD STE 150
FRONTENAC MO
63131-2909
US

V. Phone/Fax

Practice location:
  • Phone: 314-960-2198
  • Fax:
Mailing address:
  • Phone: 314-960-2198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2008015941
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: