MEDICARE: DR. JEFF E REINKING DDS

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	5928	IA

General Provider Information

NPI Number	:	1629027701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFF E REINKING DDS

Provider Business Mailing Address
First Line	:	480 BAYHILL CIRCLE
Second Line	:
City	:	DAKOTA DUNES
State	:	SD
Zip	:	57049
Country	:	US
Telephone Number	:	605-422-5678
Fax Number	:	712-255-1526

Provider Business Practice Location Address
First Line	:	2410 PIERCE ST
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-3724
Country	:	US
Telephone Number	:	712-255-7123
Fax Number	:	712-255-1526

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

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	07/08/2007

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