DR. REVIVAJENNZ MED SPA, PLLC
NPI 1083310312
Clinic/Center in Ann Arbor, MI

Q: What is Dr. Revivajennz Med Spa, PLLC's NPI number?

The NPI number for Dr. Revivajennz Med Spa, PLLC is 1083310312. It was assigned to this organization in the NPPES registry on February 7, 2023.

Q: What is Dr. Revivajennz Med Spa, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Active since February 07, 2023

418 S WAGNER RD, ANN ARBOR, MI 48103(734) 355-3566 Get Directions Write a Review

NPPES record last updated: February 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Revivajennz Med Spa, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. REVIVAJENNZ MED SPA, PLLC (NPI 1083310312) is a healthcare organization registered as a clinic/center in Ann Arbor, Michigan and active in the NPI registry since February 2023. The organization lists Jennifer Thomas-goering, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1083310312

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameDR. REVIVAJENNZ MED SPA, PLLC

Location Address418 S WAGNER RDAnn Arbor, MI 48103-1944

Mailing Address4870 Birkdale DrAnn Arbor, MI 48103-9743 · (734) 355-3566

Phone(734) 355-3566

Organization SubpartNo

Authorized OfficialJennifer Thomas-goeringMedical Director · (734) 355-3566

Enumeration DateFebruary 7, 2023

NPPES CertifiedFebruary 7, 2023

✔ NPI 1083310312 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

418 S WAGNER RD, Ann Arbor, MI 48103

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dr. Revivajennz Med Spa, PLLC's NPI number?

The NPI number for Dr. Revivajennz Med Spa, PLLC is 1083310312. It was assigned to this organization in the NPPES registry on February 7, 2023.

Where is Dr. Revivajennz Med Spa, PLLC located?

Dr. Revivajennz Med Spa, PLLC is located at 418 S Wagner Rd, Ann Arbor, MI 48103. The listed phone number is (734) 355-3566.

What is Dr. Revivajennz Med Spa, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Dr. Revivajennz Med Spa, PLLC was last updated on February 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.