Provider Demographics
NPI:1518576180
Name:REYNOLDS, SARAH DAVINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:DAVINA
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 WINBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052-6112
Mailing Address - Country:US
Mailing Address - Phone:817-526-2015
Mailing Address - Fax:
Practice Address - Street 1:552 WINBRIDGE LN
Practice Address - Street 2:
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052-6112
Practice Address - Country:US
Practice Address - Phone:817-526-2015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36438122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist