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REVERE DENTAL
NPI 1790479210
Clinic/Center - Dental in Bourbonnais, IL

Active since June 07, 2023
588 WILLIAM LATHAM DR STE 2, BOURBONNAIS, IL 60914(815) 933-6100 Get Directions Write a Review

NPPES record last updated: June 7, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Revere Dental NPPES

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

REVERE DENTAL (NPI 1790479210) is a healthcare organization registered as a dental in Bourbonnais, Illinois and active in the NPI registry since June 2023. The organization lists Peter Girgis, Dentist, as its authorized official.

NPPES Registry Identity

NPI1790479210
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameREVERE DENTAL
Location Address588 WILLIAM LATHAM DR STE 2Bourbonnais, IL 60914-2340
Mailing Address588 William Latham Dr Ste 2Bourbonnais, IL 60914-2340
Phone(815) 933-6100
Organization SubpartNo
Authorized OfficialPeter GirgisDentist · (815) 933-6100
Enumeration DateJune 7, 2023
NPPES CertifiedJune 6, 2023
✔ NPI 1790479210 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
588 WILLIAM LATHAM DR STE 2, Bourbonnais, IL 60914
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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 Revere Dental's NPI number?

The NPI number for Revere Dental is 1790479210. It was assigned to this organization in the NPPES registry on June 7, 2023.

Where is Revere Dental located?

Revere Dental is located at 588 William Latham Dr Ste 2, Bourbonnais, IL 60914. The listed phone number is (815) 933-6100.

What is Revere Dental's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Revere Dental was last updated on June 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.