Provider Demographics
NPI:1285847137
Name:REYNOLDS, BILLY D (DMD)
Entity Type:Individual
Prefix:DR
First Name:BILLY
Middle Name:D
Last Name:REYNOLDS
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 1:1636 NICHOLASVILLE RD
Mailing Address - Street 2:STE 7
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1425
Mailing Address - Country:US
Mailing Address - Phone:859-278-0576
Mailing Address - Fax:859-276-2473
Practice Address - Street 1:1636 NICHOLASVILLE RD
Practice Address - Street 2:STE 7
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1425
Practice Address - Country:US
Practice Address - Phone:859-278-0576
Practice Address - Fax:859-276-2473
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6361122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist