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NPI Code Detail

MEDICARE: DR. ROBERTO REYES DMD

MEDICARE: DR. ROBERTO REYES 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
11223D0001XPublic Health Dentistry5996OK

General Provider Information

NPI Number : 1265533178
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERTO REYES DMD
Provider Business Mailing Address
First Line : 22103 E 101ST PL S
Second Line :
City : BROKEN ARROW
State : OK
Zip : 74014-4332
Country : US
Telephone Number : 787-402-1536
Fax Number :
Provider Business Practice Location Address
First Line : 10321 N 2274 RD
Second Line :
City : CLINTON
State : OK
Zip : 73601-7521
Country : US
Telephone Number : 158-032-3288
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 10/06/2025

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Directions to “ DR. ROBERTO REYES DMD” Practice Location

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