MEDICARE: DR. ROGER REYNOLDS III 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	1223P0300X	Periodontics	3599	NC

General Provider Information

NPI Number	:	1669595484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROGER REYNOLDS III DDS

Provider Business Mailing Address
First Line	:	3809 FORRESTGATE DR STE A
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-2982
Country	:	US
Telephone Number	:	336-768-9010
Fax Number	:

Provider Business Practice Location Address
First Line	:	3809 FORRESTGATE DR STE A
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-2982
Country	:	US
Telephone Number	:	336-768-9010
Fax Number	:

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

Provider Enumeration Date	:	04/08/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1801053475 — ROGER N REYNOLDS 111 DDS MS PA
Practice Location Address:

3809 FORRESTGATE DR , SUITE A
WINSTON SALEM, NC
27103-2982

Practice Phone: 336-768-9010
Practice Fax: 336-768-9011

1780834457 — NICOLE R WRIGHT D.D.S.
Practice Location Address:

3809 FORRESTGATE DR STE A
WINSTON SALEM, NC
27103-2982

Practice Phone: 336-768-9010
Practice Fax: 336-768-9011

1750082269 — MICHAEL CHOI
Practice Location Address:

3809 FORRESTGATE DR # 5
WINSTON SALEM, NC
27103-2982

Practice Phone: 336-768-9010
Practice Fax:

1255188322 — NICOLE R. MILLER, DDS PA
Practice Location Address:

3809 FORRESTGATE DR STE A
WINSTON SALEM, NC
27103-2982

Practice Phone: 336-768-9010
Practice Fax: 336-768-9011

1881564458 — LONDRY & MODLIN XVIII DDS PLLC
Practice Location Address:

3809 FORRESTGATE DR STE A
WINSTON SALEM, NC
27103-2982

Practice Phone: 743-255-8011
Practice Fax:

1134574080 — ANNA FRANCESCA SCHUBERT
Practice Location Address:

101 E 6TH ST , APT 405B
WINSTON SALEM, NC
27101-2982

Practice Phone: 303-519-4101
Practice Fax:

Directions to “ DR. ROGER REYNOLDS III DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.