Provider Demographics
NPI:1215158274
Name:REIF, REGINALD (RPH, DDS)
Entity type:Individual
Prefix:DR
First Name:REGINALD
Middle Name:
Last Name:REIF
Suffix:
Gender:M
Credentials:RPH, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 HARDY DR
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-3483
Mailing Address - Country:US
Mailing Address - Phone:913-707-5932
Mailing Address - Fax:
Practice Address - Street 1:9900 HARDY DR
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-3483
Practice Address - Country:US
Practice Address - Phone:913-707-5932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-08919183500000X
KS49971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS4997OtherDENTIST
KS8919OtherPHARMACIST