OrganizationActive
Dr. Revivajennz Med Spa, PLLC
NPI 1083310312 · Clinic/Center · Ann Arbor, MI
Provider details
- NPI number
- 1083310312
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jennifer Thomas-Goering, Medical Director(734) 355-3566
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(59/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES 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
418 S Wagner Rd
Ann Arbor, MI 48103-1944
Phone: (734) 355-3566
Street-level locationGet directions
Mailing address
4870 Birkdale Dr
Ann Arbor, MI 48103-9743
Registry dates
- Enumerated
- 2023-02-07
- Last updated
- 2023-02-07
- Certified
- 2023-02-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.