Victoria Ashley Revich, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02829000 Issued in NJ

Practice address

1630 Riverton Rd
Cinnaminson, NJ 08077-2343

Phone

(732) 996-9758

NPI assigned

Nov 14, 2019

Last updated

Oct 2, 2021By the provider in NPPES

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 16, 2022 through Jun 16, 2028

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michael Vanaria, DMD, PC

  dba Vanaria Dental

  • Dentist
  • Woodbury, NJ
  • NPI 1558722785
  NPD (past)

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633132800000",
    "number": "1235774084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 RIVERTON RD",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080772343",
            "telephone_number": "329-996-9758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 RIVERTON RD",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080772343",
            "telephone_number": "732-996-9758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVICH",
        "first_name": "VICTORIA",
        "middle_name": "ASHLEY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2021-10-02",
        "certification_date": "2021-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02829000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph James Reda Jr., O.D.
• Regional Radiology LLC
• Lisa M Rein, RN
• Edward Jay Reisner, D.M.D.
• Rem New Jersey Inc
• Frederick R Reynolds II, ATC, USAW-SPC
• Ride and Care Transportation
• Rite Aid
• Rite Aid of New Jersey Inc (Rite Aid Pharmacy 00833)
• Amanda Robinson, APN

• Dentist in Cinnaminson, NJ
• Providers in Cinnaminson, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.