Provider Demographics
NPI:1225049943
Name:REAMS, GREGORY JAMES (DMD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:JAMES
Last Name:REAMS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 682
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132
Mailing Address - Country:US
Mailing Address - Phone:503-670-1592
Mailing Address - Fax:503-624-9610
Practice Address - Street 1:7105 SW HAMPTON STREET
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-9314
Practice Address - Country:US
Practice Address - Phone:503-684-9274
Practice Address - Fax:503-624-9610
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD55361223E0200X
WADE00069431223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics