DR. ROGER REYNOLDS III (NPI# 1669595484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669595484 |
| Entity Type | Individual |
| Full Name | DR. ROGER REYNOLDS III |
| Credential | DDS |
| Practice Address |
3809 Forrestgate Dr Ste A Winston Salem NC 27103-2982 |
| Practice Telephone | 3367689010 |
| Mailing Telephone | 3367689010 |
| Enumeration Date | 2007-04-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
3599 | NC | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225659709 | Roger Wayne Reynolds Sr. | Driver | 14531 Douglas Ln, Abingdon, VA 24210-4827 | 2020-05-06 |
| 1376687939 | Roger M Reynolds | Social Worker | 1475 Pine Grove Rd., Suite 206, Steamboat Spgs, CO 80487 | 2007-02-16 |
| 1952845760 | Roger Reynolds | Case Manager/Care Coordinator | 1017 Fayetteville Rd Se, Atlanta, GA 30316-2932 | 2016-12-13 |
| 1689682254 | Roger Reynolds | Family Medicine | 1825 Maple St, Forest Grove, OR 97116-1939 | 2006-08-03 |
| 1760478747 | Roger I. Reynolds | Pharmacist | 701 Commercial St, Atchison, KS 66002-2434 | 2005-09-23 |
| Street Address |
3809 FORRESTGATE DR STE A |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-2982 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780834457 | Nicole R Wright | Dentist | 3809 Forrestgate Dr Ste A, Winston Salem, NC 27103-2982 | 2008-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295860690 | W. Mark Suttle, Dds, Ms, Pa | Dentist | 1617 S. Hawthorne Road, Winston Salem, NC 27103 | 2007-02-23 |
| 1780834457 | Nicole R Wright | Dentist | 3809 Forrestgate Dr Ste A, Winston Salem, NC 27103-2982 | 2008-09-30 |
| 1194941807 | William Mark Suttle | Dentist | 1617 S Hawthorne Rd, Winston Salem, NC 27103-4127 | 2007-04-18 |
| 1245456979 | Dudley C. Chandler Jr. | Dentist | 1617 S Hawthorne Rd, Winston Salem, NC 27103-4127 | 2007-04-18 |
| 1447394556 | Kenneth Alton Peavy | Dentist | 1400 Westgate Center Dr, Suite 204, Winston Salem, NC 27103-3104 | 2007-02-20 |
| 1710903711 | William Carroll Broome | Dentist | 201 Charlois Blvd, Winston Salem, NC 27103-1507 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023623113 | Yoon Chi | Dentist | 385 S Columbia St Suite 123 Brauer Hall, Chapel Hill, NC 27599-7450 | 2020-09-15 |
| 1962044560 | Riccobene & Associates Xxxvi, Dds, P.a. | Dentist | 2250 Shipyard Blvd Ste 14, Wilmington, NC 28403-8070 | 2019-10-15 |
| 1255985016 | Farahnaz Fahimipour | Dentist | 123 Brauer Hall Department of Periodontology, Chapel Hill, NC 27599-0001 | 2019-07-30 |
| 1982257838 | Amanda Finger Stadler | Dentist | Unc Adams School of Dentistry Brauer 140, Chapel Hill, NC 27599-0001 | 2019-07-19 |
| 1528542073 | Sing Wai Wong | Dentist | 140 Dental Cir Chapel Hill Brauer Hall Room 123, Chapel Hill, NC 27599-7450 | 2018-09-20 |
| 1174030415 | Craig Dorion Dds Mph Pa IIi | Dentist | 2310 Myron Dr Ste 100, Raleigh, NC 27607-3358 | 2018-01-09 |
| 1952824807 | Vishal Gohel | Dentist | Department of Periodontology Unc School Of, Chapel Hill, NC 27599-0001 | 2017-07-24 |
| 1154709251 | Lance Hutchens | Dentist | 1611 Doctors Cir, Wilmington, NC 28401 | 2015-05-11 |
| 1568853943 | Mais Sweidan | Dentist | 123 Brauer Hl, Campus Box 7450, Chapel Hill, NC 27599-0001 | 2015-02-06 |
| 1316353956 | Elizabeth Campbell | Dentist | 150 Providence Rd Ste 200, Chapel Hill, NC 27514-2208 | 2014-07-03 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.