Provider Demographics
NPI:1881785632
Name:REYNOLDS, DONALD FLOYD (D D S)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:FLOYD
Last Name:REYNOLDS
Suffix:
Gender:M
Credentials:D D S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7008 CLEMSON DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22307-1708
Mailing Address - Country:US
Mailing Address - Phone:703-765-4947
Mailing Address - Fax:
Practice Address - Street 1:2000 HUNTINGTON AVE STE 107
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22303-1728
Practice Address - Country:US
Practice Address - Phone:703-960-8670
Practice Address - Fax:703-960-0267
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010034171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice