Eleanor Maria Revelis, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

8068 Issued in NE

Practice address

7631 Cass St
Omaha, NE 68114-3623

Phone

(402) 393-0594

NPI assigned

May 20, 2024

Last updated

Apr 7, 2025By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Smiles 4 Kids PC

  • General Practice Dentistry
  • Omaha, NE
  • NPI 1487902581
  NPD

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1720827934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N9023 LAKESHORE RD",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530835123",
            "telephone_number": "920-918-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7631 CASS ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143623",
            "telephone_number": "402-393-0594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1105 Howard St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681022841",
            "country_code": "US",
            "telephone_number": "402-505-4424",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7650 W Virginia Ave",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802263131",
            "country_code": "US",
            "telephone_number": "303-222-0296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REVELIS",
        "first_name": "ELEANOR",
        "middle_name": "MARIA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-20",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00206047",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "8068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Weston Reuben
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• Brenna Reusink
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• Michele A Reuter
• Shelby Lynn Revell
• Natalya Revenkov
• Joseph Revers
• Jamie Lynn Revielle, DDS
• Revision Psychotherapy LLC

• Dentist in Omaha, NE
• Providers in Omaha, NE by specialty
• Dentist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.