Provider Demographics
NPI:1366705857
Name:REAVES, CAITLIN COX (DMD)
Entity type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:COX
Last Name:REAVES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:CAITLIN
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:2828 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2504
Mailing Address - Country:US
Mailing Address - Phone:205-332-3886
Mailing Address - Fax:205-332-3887
Practice Address - Street 1:2828 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-2504
Practice Address - Country:US
Practice Address - Phone:205-332-3886
Practice Address - Fax:205-332-3887
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD5911122300000X, 1223P0221X
SC8479122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL281203Medicaid