Healthcare Provider Details

I. General information

NPI: 1700404092
Provider Name (Legal Business Name): REED ALAN MCKINNEY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3551 ROGER BROOKE DR
FORT SAM HOUSTON TX
78234-4504
US

IV. Provider business mailing address

3551 ROGER BROOKE DR
FORT SAM HOUSTON TX
78234-4504
US

V. Phone/Fax

Practice location:
  • Phone: 812-521-2513
  • Fax:
Mailing address:
  • Phone: 812-521-2513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number12013381A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number12013381A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number12013381A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: