Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
JACK K. REYNOLDS DDS PA
Active
Organization
JACK K. REYNOLDS DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHARON ELAINE REYNOLDS LUNDGREN (D.D.S)
(410) 676-5252
Entity
Organization
Contact information
Practice address
2104 TRIMBLE RD, EDGEWOOD, MD 21040-3126
(410) 676-5252
(410) 679-4068
Mailing address
PO BOX 696, EDGEWOOD, MD 21040-0696
(410) 676-5252
(410) 679-4068
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
817292
UNITED CONCORDIA
MD
Enumeration date
07/22/2008
Last updated
07/22/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers