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OrganizationActive

Revive Dentistry, Pllc

Clinic/Center - Dental

OMID KHEZRI
NPI: 1023975547Orange City, Florida, 32763(386) 775-4300

About Revive Dentistry, Pllc

Revive Dentistry, Pllc is a healthcare organization providing Clinic/Center - Dental services, with specialized expertise in Dental, registered under National Provider Identifier (NPI) number 1023975547.

The authorized official for Revive Dentistry, Pllc is OMID KHEZRI. The organization is headquartered at 272 E GRAVES AVE, Orange City, Florida 32763. The main office can be reached at (386) 775-4300. Revive Dentistry, Pllc has been NPI-registered since 2026.

Locations & Contact

Primary Location

Address
272 E GRAVES AVE
City
Orange City
State
Florida
ZIP
32763-5269
Phone
(386) 775-4300
Fax
(386) 775-0630
View on Google Maps

Authorized Official

Name
OMID KHEZRI

Mailing Address

Address
272 E GRAVES AVE
City
ORANGE CITY
State
FL
ZIP
327635269

NPI Registration

Enumeration Date
Last Updated
Certification Date

Services & Taxonomy

Specialty & Classification

Primary Specialty
Clinic/Center - Dental
Classification
Clinic/Center
Specialization
Dental
Taxonomy Code
261QD0000X

Medicare Enrollment

Medicare Enrolled
No
Can Order/Refer
No
Telehealth
No
Excluded
No

Frequently Asked Questions

What is Revive Dentistry, Pllc's NPI number?
Revive Dentistry, Pllc's National Provider Identifier (NPI) is 1023975547. An NPI is a unique 10-digit identification number issued by the Centers for Medicare & Medicaid Services (CMS) to healthcare providers in the United States.
What does Revive Dentistry, Pllc specialize in?
Revive Dentistry, Pllc specializes in Clinic/Center - Dental.
Where is Revive Dentistry, Pllc located?
Revive Dentistry, Pllc practices at 272 E GRAVES AVE, Orange City, Florida 32763. You can reach them by phone at (386) 775-4300.
Does Revive Dentistry, Pllc accept Medicare?
Based on available data, Revive Dentistry, Pllc is not currently enrolled in the Medicare program.
Does Revive Dentistry, Pllc offer telehealth or virtual visits?
Revive Dentistry, Pllc does not currently offer telehealth services. In-person visits are required at their practice location.

What is a Type 2 NPI (Organization)?

A Type 2 NPI is assigned to healthcare organizations such as hospitals, group practices, clinics, and other medical entities. Unlike Type 1 NPIs issued to individual providers, a Type 2 NPI identifies the organization itself and is used for billing, claims processing, and identification in healthcare transactions. Revive Dentistry, Pllc holds NPI 1023975547, which serves as its unique identifier across all Medicare and HIPAA-covered transactions.