DR. JESSICA RUSSO REVAND DMD, MS
NPI 1770712705
Dentist - Endodontics in Alexandria, VA

Q: What is Jessica Russo Revand's NPI number?

The NPI number for Jessica Russo Revand is 1770712705. It was assigned to this individual provider in the NPPES registry on July 13, 2009.

Q: What is Jessica Russo Revand's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Q: Is Jessica Russo Revand enrolled in Medicare?

No. Jessica Russo Revand has opted out of Medicare through May 23, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Active since July 13, 2009Opted out of Medicare · through May 23, 2028

4660 KENMORE AVE, SUITE 700, ALEXANDRIA, VA 22304(703) 370-1327(703) 370-1907 Get Directions Write a Review

NPPES record last updated: July 13, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dr. Jessica Russo Revand Dmd, Ms NPPES

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

DR. JESSICA RUSSO REVAND DMD, MS (NPI 1770712705) is an individual endodontics provider in Alexandria, Virginia, licensed in Virginia (0401412509) and active in the NPI registry since July 2009. She has opted out of Medicare through May 23, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1770712705

Entity TypeIndividualFemale

Primary Taxonomy1223E0200X

Provider Legal NameDR. JESSICA RUSSO REVANDCredential: DMD, MS

Location Address4660 KENMORE AVE, SUITE 700Alexandria, VA 22304-1313

Mailing Address4660 Kenmore Ave, Suite 700Alexandria, VA 22304-1313 · (703) 370-1327 · Fax (703) 370-1907

Phone(703) 370-1327

Fax(703) 370-1907

Sole ProprietorYes

Enumeration DateJuly 13, 2009

✔ NPI 1770712705 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · EndodonticsDental Providers

Taxonomy Code1223E0200X

Licenses✔ Licensed in VA · 0401412509✔ Licensed in DC · DEN1000827✔ Licensed in CA · 51517

Definition

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

4660 KENMORE AVE, Alexandria, VA 22304

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jessica Russo Revand Dmd, Ms has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 23, 2016 through May 23, 2028.

Opt-Out Effective DateMay 23, 2016

Opt-Out In Effect ThroughMay 23, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22304 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$100.31 typical visit price

range $65.18 – $194.86

Typical copayment $25.07 (range $16.29 – $48.71)

Most-billed visit code 99203

Established Patient

$80.66 typical visit price

range $21.40 – $158.88

Typical copayment $20.16 (range $5.35 – $39.72)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KENNETH MICHAEL AHDOOT MD

Obstetrics & Gynecology

4660 KENMORE AVE, SUITE #902
ALEXANDRIA, VA 22304

Alexandria City (703) 370-4300

STEFANO FRANCO AGOLINI

Surgery

4660 KENMORE AVE, SUITE 419
ALEXANDRIA, VA 22304

Alexandria City (703) 823-4066

KELLY L COOPER PT

Physical Therapist

4660 KENMORE AVE, SUITE 420
ALEXANDRIA, VA 22304

Alexandria City (703) 751-1008

NIYADELL, INC

Technician/Technologist (Optician)

4660 KENMORE AVE, SUITE 101
ALEXANDRIA, VA 22304

Alexandria City (703) 751-2800

GEORGE W TAWIL MD

Urology

4660 KENMORE AVE, SUITE 735
ALEXANDRIA, VA 22304

Alexandria City (703) 370-2132

COMPUTED TOMOGRAPHY ASSOCIATES

Radiology (Diagnostic Radiology)

4660 KENMORE AVE, SUITE 608
ALEXANDRIA, VA 22304

Alexandria City (703) 824-3260

MS. GINA KARLIN HALDEMAN CNM

Nurse Practitioner (Obstetrics & Gynecology)

4660 KENMORE AVE, #902
ALEXANDRIA, VA 22304

Alexandria City (703) 370-4300

DR. KRISTINA KATHLEEN HIBSHMAN M.D.

Obstetrics & Gynecology

4660 KENMORE AVE, SUITE 1100
ALEXANDRIA, VA 22304

Alexandria City (703) 370-0400

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 Jessica Russo Revand's NPI number?

The NPI number for Jessica Russo Revand is 1770712705. It was assigned to this individual provider in the NPPES registry on July 13, 2009.

Where is Jessica Russo Revand located?

Jessica Russo Revand practices at 4660 Kenmore Ave Suite 700, Alexandria, VA 22304. The listed phone number is (703) 370-1327.

What is Jessica Russo Revand's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Is Jessica Russo Revand enrolled in Medicare?

No. Jessica Russo Revand has opted out of Medicare through May 23, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Jessica Russo Revand accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and HRI Dental & Vision and 4 other insurers list Jessica Russo Revand as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jessica Russo Revand was last updated on July 13, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.