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Individual
DR. ALLEN BLEY REAVIS
Active
Individual
DR. ALLEN BLEY REAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
14104
MO
1223G0001X
General Practice Dentistry
Primary
6084
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10022285B
—
KS
01
—
116750
BCBS
—
01
—
9176546
DORAL MEDICAID
KS
Enumeration date
01/25/2006
Last updated
07/13/2026
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