Revive Dental Studio LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

REVIVE DENTAL STUDIO LLC

Practice address

10 W Hanover Ave Ste 101
Randolph, NJ 07869-4221

Phone

(973) 895-4333

NPI assigned

Jun 10, 2022

Last updated

Jun 10, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Azadeh May Dianat, DDSNPI 1841787769

Title

Manager

Phone

(404) 578-4423

Specialties & licenses 1

Addresses

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Azadeh May Dianat

  • General Practice Dentistry
  • Brooklyn, NY
  • NPI 1841787769
  NPD Authorized official
• Jack Gershenhorn, DDS

  • General Practice Dentistry
  • Randolph, NJ
  • NPI 1225144363
  NPD (past)
• Philip S Messer, DDS

  • Dentist
  • Garwood, NJ
  • NPI 1447539879
  NPD (past)

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654819200000",
    "number": "1356071617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 N 11TH ST APT 7D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112111134",
            "telephone_number": "404-578-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 W HANOVER AVE STE 101",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078694221",
            "telephone_number": "973-895-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE DENTAL STUDIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A",
        "authorized_official_last_name": "DIANAT",
        "authorized_official_first_name": "AZADEH",
        "authorized_official_middle_name": "MAY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-578-4423",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eva Reinhart, M.D.
• Harald Reinhart, M.D.
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• Christina Resz, CCC-SLP
• Reynolds Pain & Wellness Center LLC
• Rhino Chiropractic (Ryan Chiropractic)
• Francesca Rich, FNP-BC
• Nina Rimarenko, PTA
• Savanah Rae Rivera

• General Practice Dentistry in Randolph, NJ
• Providers in Randolph, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.