Provider Demographics
NPI:1609688795
Name:REYES, MONIQUE YVONNE (RDH)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:YVONNE
Last Name:REYES
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 APRYL CT
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-2039
Mailing Address - Country:US
Mailing Address - Phone:410-652-2917
Mailing Address - Fax:
Practice Address - Street 1:8600 LASALLE ROAD
Practice Address - Street 2:SUITE 507
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286
Practice Address - Country:US
Practice Address - Phone:410-321-8480
Practice Address - Fax:410-321-8482
Is Sole Proprietor?:No
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4830124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist