Provider Demographics
NPI:1427258342
Name:REID, CHAD MONROE (DDS)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:MONROE
Last Name:REID
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29933 E HWY 51
Mailing Address - Street 2:
Mailing Address - City:COWETA
Mailing Address - State:OK
Mailing Address - Zip Code:74429
Mailing Address - Country:US
Mailing Address - Phone:918-279-7100
Mailing Address - Fax:918-279-6430
Practice Address - Street 1:29933 E STATE HIGHWAY 51
Practice Address - Street 2:
Practice Address - City:COWETA
Practice Address - State:OK
Practice Address - Zip Code:74429-7684
Practice Address - Country:US
Practice Address - Phone:918-279-7100
Practice Address - Fax:918-279-6430
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK59581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200210270AMedicaid
OK200201780AMedicaid