MICHAEL JOHN REVENIG (NPI# 1487711545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487711545 |
| Entity Type | Individual |
| Full Name | MICHAEL JOHN REVENIG |
| Credential | DDS |
| Practice Address |
4601 Brainerd Rd Chattanooga TN 37411-3826 |
| Practice Telephone | 4236986005 |
| Practice Fax Number | 4236986410 |
| Mailing Telephone | 4236986005 |
| Mailing Fax Number | 4236986410 |
| Enumeration Date | 2007-01-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DS0000002186 | TN | Dental Providers |
| Street Address |
4601 BRAINERD RD |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37411-3826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821420464 | Michael J.revenig Dds, Glenn D. Wilson Dds, Pllc | Dentist | 4601 Brainerd Rd, Chattanooga, TN 37411-3826 | 2013-08-06 |
| 1730230111 | Glenn Dean Wilson | Dentist | 4601 Brainerd Rd, Chattanooga, TN 37411-3826 | 2007-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811520620 | Winzetta Jenkins | Social Worker | 5705 Uptain Rd., Chattanooga, TN 37411 | 2020-02-20 |
| 1881156651 | Valerie L Radu | Social Worker | 5800 Uptain Road, Suite 1200, Chattanooga, TN 37411 | 2019-04-02 |
| 1568986693 | Solution Transportation Services, Inc | Non-emergency Medical Transport (VAN) | 4707 North Terrace, Chattanooga, TN 37411 | 2017-07-31 |
| 1689060733 | Nirlepkumar Patel | Pharmacist | 3602 Brainerd Road, Chattanooga, TN 37411 | 2015-04-15 |
| 1669896254 | Audra Valentaviciene | Nurse Practitioner | 5618 Brainerd Road, Chattanooga, TN 37411 | 2014-02-18 |
| 1376973198 | Kelly Leigh Kennedy | Nurse Practitioner | 5600 Brainerd Road, Suite B14, Chattanooga, TN 37411 | 2013-11-14 |
| 1417210071 | Jason Owen Blair | Physical Therapy Assistant | 5779 Brainard Rd, Chattanooga, TN 37411 | 2012-06-19 |
| 1447532270 | Masons and Daughter LLC | Non-emergency Medical Transport (VAN) | 7 North Tuxedo Ave, Chattanooga, TN 37411 | 2011-09-19 |
| 1841500386 | Pamela Denise Stultz | Physical Therapy Assistant | 3207 Rosemont Drive, Chattanooga, TN 37411 | 2010-10-18 |
| 1689803843 | Pauline Evans | Occupational Therapy Assistant | 1557 Pin Oak Dr, Chattanooga, TN 37411 | 2009-07-09 |
| Find all providers in zip 37411 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093360794 | Dr. Drew Shabo LLC | Dentist | 1309 Panorama Dr, Chattanooga, TN 37421-4770 | 2019-08-08 |
| 1356901946 | Tn Dental Professionals PC | Dentist | 1309 Panorama Dr Ste 101, Chattanooga, TN 37421-4771 | 2019-06-17 |
| 1447743653 | Tyler Fielding Mccubbins | Dentist | 1612 Gunbarrel Rd Ste 102, Chattanooga, TN 37421-4135 | 2018-06-12 |
| 1083134977 | Evan Scott Myers | Dentist | 951 Riverfront Pkwy Ste 101, Chattanooga, TN 37402-2185 | 2017-06-22 |
| 1851829162 | Adam Nathaniel Parker | Dentist | 7030 Lee Hwy Ste 101, Chattanooga, TN 37421-6795 | 2017-05-31 |
| 1770988834 | 32 Dental, LLC | Dentist | 7333 Shallowford Rd, Chattanooga, TN 37421-2627 | 2014-10-30 |
| 1497168579 | Mark S. Cowart, D.d.s. Inc | Dentist | 4355 Highway 58 Ste 103a, Chattanooga, TN 37416-2941 | 2014-06-06 |
| 1447508098 | Frederick H Thompson | Dentist | 4109 Mountain View Ave, Suite 300, Chattanooga, TN 37415-2096 | 2012-08-29 |
| 1699044487 | Constance Chamberlain Wise | Dentist | 4300 Dayton Blvd, Chattanooga, TN 37415 | 2011-12-22 |
| 1316125354 | Mark Stephen Dill | Dentist | 6102 Shallowford Rd Ste 101, Chattanooga, TN 37421-1684 | 2008-02-01 |
| Find all providers in CHATTANOOGA | ||||
| City | CHATTANOOGA |
| Zip Code | 37411 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.