Provider Demographics
NPI:1154746113
Name:POMPEI-REYNOLDS, RENEE (DDS)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:
Last Name:POMPEI-REYNOLDS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:RENEE
Other - Middle Name:C
Other - Last Name:POMPEI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:357 8TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-7598
Mailing Address - Country:US
Mailing Address - Phone:212-484-0711
Mailing Address - Fax:
Practice Address - Street 1:357 8TH AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001
Practice Address - Country:US
Practice Address - Phone:212-484-0711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-27
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI025621001223X0400X
NY50 0566301223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics