Provider Demographics
NPI:1730761875
Name:REYES, JULIANNE MUNOZ (RDH)
Entity type:Individual
Prefix:MRS
First Name:JULIANNE
Middle Name:MUNOZ
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 1:500 OMAR ST APT 106
Mailing Address - Street 2:
Mailing Address - City:ANTHONY
Mailing Address - State:TX
Mailing Address - Zip Code:79821-9366
Mailing Address - Country:US
Mailing Address - Phone:575-520-4961
Mailing Address - Fax:
Practice Address - Street 1:1405 S VALLEY DR # 300
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-3132
Practice Address - Country:US
Practice Address - Phone:575-532-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDH5163124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist