Provider Demographics
NPI:1447466180
Name:REED, JILL ALEXIS (DMD)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:ALEXIS
Last Name:REED
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1285 NE 101ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2608
Mailing Address - Country:US
Mailing Address - Phone:305-751-8065
Mailing Address - Fax:
Practice Address - Street 1:660 NE 95TH ST
Practice Address - Street 2:SUITE #5
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2758
Practice Address - Country:US
Practice Address - Phone:305-758-0404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL00109621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice