MEDICARE: NATALIE NICOLE REED 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
1	122300000X	Dentist	7477	OK

General Provider Information

NPI Number	:	1770267817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE NICOLE REED DMD

Provider Business Mailing Address
First Line	:	12113 E 69TH ST N
Second Line	:
City	:	OWASSO
State	:	OK
Zip	:	74055-3629
Country	:	US
Telephone Number	:	918-639-6505
Fax Number	:

Provider Business Practice Location Address
First Line	:	5639 E 41ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74135-6010
Country	:	US
Telephone Number	:	918-622-3354
Fax Number	:

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

Provider Enumeration Date	:	06/09/2023
Last Update Date	:	10/02/2024

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