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NPI Code Detail

MEDICARE: DR. JOHNNY REID DMD

MEDICARE:  DR. JOHNNY  REID  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry0401008226VA

General Provider Information

NPI Number : 1124106182
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHNNY REID DMD
Provider Business Mailing Address
First Line : PO BOX 29452
Second Line :
City : RICHMOND
State : VA
Zip : 23242-0452
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4722 N SOUTHSIDE PLAZA ST # 24
Second Line :
City : RICHMOND
State : VA
Zip : 23224-1742
Country : US
Telephone Number : 804-230-4758
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JOHNNY REID DMD” Practice Location

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