Revive Dental Livonia

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

REVIVE DENTAL LIVONIA

Practice address

31544 Schoolcraft Rd
Livonia, MI 48150-1805

Phone

(248) 943-0907

NPI assigned

Jul 10, 2025

Organization subpart

No

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

Authorized official

Name

Vincent Dawisha, DDSNPI 1265923544

Title

Partner

Phone

(248) 444-3847

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Vincent Dawisha

  • General Practice Dentistry
  • Troy, MI
  • NPI 1265923544
  NPD Authorized official

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

{
    "created_epoch": "1752105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752105600000",
    "number": "1679464507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31544 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31544 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501805",
            "telephone_number": "248-943-0907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE DENTAL LIVONIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-10",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-09",
        "status": "A",
        "authorized_official_last_name": "DAWISHA",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "248-444-3847",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cere Louise Rettig
• Melissa Anne Rettmann, PA-C
• Mara Rey Leyes
• Stephanie Marie Reyburn
• Jose Guadalupe Reyes, PTA
• Hunter Reynolds
• Rebekah Reynolds, LPC

• General Practice Dentistry in Livonia, MI
• Providers in Livonia, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.