Provider Demographics
NPI:1801262985
Name:REID, OMAR ALEXANDER (DDS)
Entity type:Individual
Prefix:DR
First Name:OMAR
Middle Name:ALEXANDER
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 1:9 TANGERINE PLACE
Mailing Address - Street 2:KINGSTON 10
Mailing Address - City:KINGSTON
Mailing Address - State:JAMAICA
Mailing Address - Zip Code:JAMAICA WI
Mailing Address - Country:JM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9 TANGERINE PLACE
Practice Address - Street 2:KINGSTON 10
Practice Address - City:KINGSTON
Practice Address - State:JAMAICA
Practice Address - Zip Code:JAMAICA WI
Practice Address - Country:JM
Practice Address - Phone:876-754-9669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1001305122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist