Pamela Ann Revel, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

7128 Issued in KY

Practice address

210 Bellaire Dr
Nicholasville, KY 40356

Phone

(859) 887-3835

Fax

(859) 887-0351

NPI assigned

Nov 29, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Revel Dental,PSC

  • General Practice Dentistry
  • Nicholasville, KY
  • NPI 1437421310
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063589877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 BELLAIRE DR",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "40356",
            "telephone_number": "859-887-3835",
            "fax_number": "859-887-0351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 BELLAIRE DR",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "40356",
            "telephone_number": "859-887-3835",
            "fax_number": "859-887-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVEL",
        "first_name": "PAMELA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "7128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reliant Medical Supplier LLC
• Renewed Performance, LLC
• Restart Clinic, PLLC
• Restoration Christian Counseling
• Revel Dental,PSC
• William Robert Revelette, MD
• Revive Ministries Inc
• Revive Ministries Inc
• Revive Ministries Inc
• Revive Ministries Inc

• Dentist in Nicholasville, KY
• Providers in Nicholasville, KY by specialty
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.