OrganizationActive
Revitalis LLC
NPI 1710788294 · Plastic Surgery within the Head & Neck (Otolaryngology) Physician · Scottsdale, AZ
Provider details
- NPI number
- 1710788294
- Entity type
- Organization
- Primary specialty
- Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Nathan Jowett, Director(480) 520-3223
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Facial Plastic Surgery Physician207YS0123X
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
7600 E Camelback Rd Ste 7
Scottsdale, AZ 85251-2106
Phone: (480) 520-3223
Fax: (480) 847-3223
Approximate (ZIP-level) locationGet directions
Mailing address
7600 E Camelback Rd Ste 7
Scottsdale, AZ 85251-2106
Registry dates
- Enumerated
- 2025-03-21
- Last updated
- 2026-05-20
- Certified
- 2026-05-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.