Reynolds, Thomas Jefferson
Reynolds, Thomas Jefferson is an individual health care provider with primary practice located at 1202 Martin Luther King Jr Way , Tacoma WA 98405-3926. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Reynolds, Thomas Jefferson can be contacted via phone (253) 441-4743.Contact Information
Primary practice address
1202 Martin Luther King Jr Way
Tacoma WA 98405-3926
Phone: (253) 441-4743
Fax: (253) 442-8840
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 30022014 | Ohio |
| Dental Providers / Dentist | 122300000X | DN00000 | Florida |
| Dental Providers / Dentist | 122300000X | DE60192688 | Washington |
Profile Details
| NPI number | 1871567016 |
|---|---|
| LBN Legal business name | Reynolds, Thomas Jefferson |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 15th, 2006 |
| Last updated | Nov 12th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871567016 | NPPES |
| Florida | MEDICAID | 076805700 | |
| Florida | MEDICAID | 252130 |
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