DR. JACK THOMAS REYNOLDS (NPI# 1942651880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942651880 |
| Entity Type | Individual |
| Full Name | DR. JACK THOMAS REYNOLDS |
| Credential | D.D.S. |
| Practice Address |
4100 Ne Vivion Rd Kansas City MO 64119-2811 |
| Practice Telephone | 8164546443 |
| Practice Fax Number | 8164543145 |
| Mailing Telephone | 8164546443 |
| Mailing Fax Number | 8164543145 |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2016-06-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2016016886 | MO | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972852879 | Jack Reynolds | Licensed Vocational Nurse | 194 Via Baja, Ventura, CA 93003-1240 | 2012-09-06 |
| 1871818120 | Jack Edward Reynolds | Counselor | 5604 Timber Ln, Oklahoma City, OK 73111-6877 | 2010-03-30 |
| 1295825123 | Jack J. Reynolds Jr. | Dentist | 1002 Oak Dr, Richmond, IN 47374-1916 | 2006-10-13 |
| Street Address |
4100 NE VIVION RD |
| City | KANSAS CITY |
| State | MO |
| Zip Code | 64119-2811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255978227 | Heath Bryan Coleman, Dds of Missouri II, LLC | Dentist | 5363 Ne Antioch Rd, Kansas City, MO 64119 | 2019-12-09 |
| 1528525219 | Lifestreams, LLC | Home Health | 5229 Ne 56th Place, Kansas City, MO 64119 | 2019-02-28 |
| 1740639798 | Daniel Sucher | Dentist | 5416 Ne Antioch Rd, Kansas City, MO 64119 | 2016-06-10 |
| 1902266885 | Mia Depriest | Pharmacy Technician | 4838 N Manchester Ave, Kansas City, MO 64119 | 2016-03-04 |
| 1376929976 | Abigail Blair | Physical Therapist | 8121 Ne 69 Highway, Kansas City, MO 64119 | 2015-08-05 |
| 1508273939 | Morgan Shockey | Dentist | 244 E Us Hwy 69, Ste 101, Claycomo, MO 64119 | 2014-07-17 |
| 1184865990 | Laura F Hanna | Psychologist | 3100 Ne 83rd Street, Suite#1001, Kansas City, MO 64119 | 2009-03-09 |
| 1114110483 | Heintz-sight 20/20, Inc | Optometrist | 7201 North M-1 Hwy, Gladstone, MO 64119 | 2007-08-21 |
| 1356533194 | Levelup Kids, Inc. | Optometrist | 5416 Ne Antioch Road, Kansas City, MO 64119 | 2007-08-15 |
| 1275738932 | Renee Christine Springer | Physical Therapist | 2901 Ne 72nd St, Gladstone, MO 64119 | 2007-06-20 |
| Find all providers in zip 64119 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104434463 | Vaidehi Trivedi | Dentist | 10818 Parallel Pkwy # Ks, Kansas City, KS 66109-3649 | 2020-07-22 |
| 1063052777 | Threemondds LLC | Dentist | 7524 State Ave, Kansas City, KS 66112-2816 | 2020-01-10 |
| 1255978227 | Heath Bryan Coleman, Dds of Missouri II, LLC | Dentist | 5363 Ne Antioch Rd, Kansas City, MO 64119 | 2019-12-09 |
| 1134772940 | Alicia Finney | Dentist | 912 E 29th St Apt 1e, Kansas City, MO 64109-1167 | 2019-07-20 |
| 1790345155 | Dina Abdul Musheinesh | Dentist | 8043 Wornall Rd Ste 203, Kansas City, MO 64114-5822 | 2019-06-18 |
| 1083177695 | Connie Lou White | Dentist | 650 East 25th Street, School of Dentistry, Kansas City, MO 64108-2784 | 2019-04-10 |
| 1649763962 | Anna Irene Jobe | Dentist | 10203 Leavenworth Rd, Kansas City, KS 66109-3005 | 2018-06-11 |
| 1407348238 | Eilise Marie O'connor | Dentist | 411 Nichols Rd Ste 200, Kansas City, MO 64112-2015 | 2018-06-06 |
| 1588182778 | Gladstone Dental Michael Gioia Dds PC | Dentist | 5106 Ne Antioch Rd, Kansas City, MO 64119-2502 | 2017-09-07 |
| 1548790629 | Tyler Koehn | Dentist | 5901 Nw 63rd Ter Ste 150, Kansas City, MO 64151-3602 | 2017-06-12 |
| Find all providers in KANSAS CITY | ||||
| City | KANSAS CITY |
| Zip Code | 64119 |
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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.