IndividualActive
Jamie Revielle, DDS
NPI 1700014354 · Pediatric Dentistry · Omaha, NE
Provider details
- NPI number
- 1700014354
- Entity type
- Individual
- Primary specialty
- Pediatric DentistryDental Providers
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- No
- License
- 6766 (NE)
Specialties & taxonomies
Dental Providers
Dental Providers
Practice location
4001 N 168th St
Omaha, NE 68116-3203
Phone: (402) 330-5535
Fax: (414) 266-5677
Approximate (ZIP-level) locationGet directions
Mailing address
22603 Sanctuary Ridge Dr
Elkhorn, NE 68022-1300
Registry dates
- Enumerated
- 2009-06-22
- Last updated
- 2026-01-29
- Certified
- 2026-01-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.