Active NPI
Rachael Anne Revell, D.D.S.
- Pediatric Dentistry
- West Des Moines, IA
National Provider Identifier
1154557197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 09012
- Practice address
- 5950 Village View Dr
Suite 200
West Des Moines, IA 50266-3844 - Phone
- (641) 521-0625
- NPI assigned
- Jun 4, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 09012 | IA | Primary |
| Pediatric Dentistry | 1223P0221X | 25847 | TX |
Addresses
Primary practice location
5950 Village View Dr
Suite 200
West Des Moines, IA 50266-3844
Mailing address
5950 Village View Dr
Suite 200
West Des Moines, IA 50266-3844
Phone (641) 521-0625
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09012 | IA | MD | Pediatric Dentist |
| 25847 | TX | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378944000000",
"number": "1154557197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5950 VILLAGE VIEW DR",
"address_2": "SUITE 200",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502663844",
"telephone_number": "641-521-0625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5950 VILLAGE VIEW DR",
"address_2": "SUITE 200",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502663844",
"telephone_number": "641-521-0625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REVELL",
"first_name": "RACHAEL",
"middle_name": "ANNE",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-04",
"last_updated": "2013-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IA",
"license": "09012",
"primary": true
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "25847",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.