Healthcare Provider Details

I. General information

NPI: 1942556808
Provider Name (Legal Business Name): MATTHEW E REYERING D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2012
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 MONTRACHET DR.
O'FALLON MO
63368
US

IV. Provider business mailing address

110 MONTRACHET DR.
O FALLON MO
63368-4897
US

V. Phone/Fax

Practice location:
  • Phone: 636-978-4848
  • Fax: 636-978-4862
Mailing address:
  • Phone: 636-978-4848
  • Fax: 636-978-4862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2012017716
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: