OrganizationActive
Revive Dentistry, PLLC
NPI 1023975547 · Dental Clinic/Center · Orange City, FL
Revive Dentistry, PLLC is a Dental Clinic/Center organization in Orange City, FL (NPI 1023975547).
Provider details
- NPI number
- 1023975547
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Omid Khezri, Dentist(765) 631-0659
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
272 E Graves Ave
Orange City, FL 32763-5269
Phone: (386) 775-4300
Fax: (386) 775-0630
Street-level locationGet directions
Mailing address
272 E Graves Ave
Orange City, FL 32763-5269
Registry dates
- Enumerated
- 2026-01-07
- Last updated
- 2026-01-07
- Certified
- 2026-01-06
Frequently asked questions
- What is Revive Dentistry, PLLC's NPI number?
- Revive Dentistry, PLLC's National Provider Identifier (NPI) is 1023975547, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Revive Dentistry, PLLC?
- Revive Dentistry, PLLC is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Revive Dentistry, PLLC located?
- Revive Dentistry, PLLC's practice location on file with NPPES is 272 E Graves Ave, Orange City, FL 32763-5269.
- What is Revive Dentistry, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Revive Dentistry, PLLC is (386) 775-4300.
- Who is the authorized official for Revive Dentistry, PLLC?
- The authorized official listed on Revive Dentistry, PLLC's NPPES record is Omid Khezri, Dentist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Revive Dentistry, PLLC's NPI active?
- Yes — Revive Dentistry, PLLC's NPI (1023975547) is active in the NPPES registry as of the last update on 2026-01-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.