MEDICARE: DR. JAMIE REITER D.D.S.

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
1	1223G0001X	General Practice Dentistry	2901019143	MI
2	122300000X	Dentist	DN17827	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	88109	OTHER	MI	DELTA DENTAL

General Provider Information

NPI Number	:	1588777650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMIE REITER D.D.S.

Provider Business Mailing Address
First Line	:	12720 S ORANGE BLOSSOM TRL
Second Line	:	# 22
City	:	ORLANDO
State	:	FL
Zip	:	32837-6225
Country	:	US
Telephone Number	:	407-240-2255
Fax Number	:

Provider Business Practice Location Address
First Line	:	12720 S ORANGE BLOSSOM TRL
Second Line	:	# 22
City	:	ORLANDO
State	:	FL
Zip	:	32837-6225
Country	:	US
Telephone Number	:	407-240-2255
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	06/24/2012

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Directions to “ DR. JAMIE REITER D.D.S.” Practice Location

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