LEVI REYNOLDS DDS
NPI 1790212470
Dentist - General Practice in Puyallup, WA

Active since May 12, 2017Opted out of Medicare · through Jan 1, 2028
2921 5TH AVE NE STE 110, PUYALLUP, WA 98372(253) 592-3687 Get Directions Write a Review

NPPES record last updated: July 26, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 26, 2022, May 12, 2017 (2 updates tracked since 2017).

About Levi Reynolds Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEVI REYNOLDS DDS (NPI 1790212470) is an individual general practice provider in Puyallup, Washington, licensed in Washington (DE60865459) and active in the NPI registry since May 2017. He has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1790212470
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameLEVI REYNOLDSCredential: DDS
Location Address2921 5TH AVE NE STE 110Puyallup, WA 98372-7044
Mailing Address2921 5th Ave Ne Ste 110Puyallup, WA 98372-7044 · (253) 841-3173
Sole ProprietorNo
Enumeration DateMay 12, 2017
Last NPPES UpdateJuly 26, 20222 updates tracked since enumeration
NPPES CertifiedJuly 26, 2022
NPI 1790212470 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License Licensed in WA · DE60865459
Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

2921 5TH AVE NE STE 110, Puyallup, WA 98372

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Levi Reynolds Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2022 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2022
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Dental)
2921 5TH AVE NE STE 110
PUYALLUP, WA 98372
Dentist
2921 5TH AVE NE STE 110
PUYALLUP, WA 98372
Dentist
2921 5TH AVE NE STE 110
PUYALLUP, WA 98372

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Levi Reynolds's NPI number?

The NPI number for Levi Reynolds is 1790212470. It was assigned to this individual provider in the NPPES registry on May 12, 2017.

Where is Levi Reynolds located?

Levi Reynolds practices at 2921 5th Ave NE Ste 110, Puyallup, WA 98372. The listed phone number is (253) 592-3687.

What is Levi Reynolds's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Levi Reynolds enrolled in Medicare?

No. Levi Reynolds has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Levi Reynolds was last updated on July 26, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.