Revive Dental, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

27280 Issued in TX

Legal business name

REVIVE DENTAL, PA

Practice address

3879 Irving Mall
K-2a
Irving, TX 75062-5159

Phone

(214) 574-4867

Fax

(469) 417-0802

NPI assigned

Aug 29, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Yong Ho Cho, DDSNPI 1285919860

Title

President

Phone

(415) 971-4727

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yong Ho Cho, D.D.S.

  • General Practice Dentistry
  • Dallas, TX
  • NPI 1285919860
  NPD (past) Authorized official
• Akhil Reddy, DDS

  • Dentist
  • Irving, TX
  • NPI 1053576447
  NPD (past)

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409270400000",
    "number": "1184024887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2728 MCKINNON ST",
            "address_2": "APT 1517",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752011602",
            "telephone_number": "415-971-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3879 IRVING MALL",
            "address_2": "K-2A",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750625159",
            "telephone_number": "214-574-4867",
            "fax_number": "469-417-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE DENTAL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-29",
        "last_updated": "2014-08-29",
        "status": "A",
        "authorized_official_last_name": "CHO",
        "authorized_official_first_name": "YONG HO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-971-4727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesuschristopher Rodriguez Renteria, CNIM
• Rosemarie Resendez, D.P.M.
• Carla Resendiz, HIS
• Jame Elaine Restau, RN, MSN, ACNS-BC
• Restore Foot and Ankle PC
• Revive Healthcare Clinic LLC
• Revolution Monitoring, LLC
• Revolution Neuromonitoring, LLC
• Merli Mabel Reyes, PHARMACY TECHNICIAN
• Kelly Reyna

• General Practice Dentistry in Irving, TX
• Providers in Irving, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.