Provider Demographics
NPI:1487903282
Name:REEDER, ALLAN RAY (DDS)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:RAY
Last Name:REEDER
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 1:2883 VENTURA ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:CA
Mailing Address - Zip Code:96007-3473
Mailing Address - Country:US
Mailing Address - Phone:530-365-0133
Mailing Address - Fax:530-365-0321
Practice Address - Street 1:1901 BARNEY RD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:CA
Practice Address - Zip Code:96007-4301
Practice Address - Country:US
Practice Address - Phone:530-365-0321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA618251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice