DR. JESSICA RUSSO REVAND (NPI# 1770712705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770712705 |
| Entity Type | Individual |
| Full Name | DR. JESSICA RUSSO REVAND |
| Credential | DMD, MS |
| Practice Address |
4660 Kenmore Ave Suite 700 Alexandria VA 22304-1313 |
| Practice Telephone | 7033701327 |
| Practice Fax Number | 7033701907 |
| Mailing Telephone | 7033701327 |
| Mailing Fax Number | 7033701907 |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2009-07-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223E0200X |
Dentist Specialization: Endodontics |
51517 | CA | Dental Providers |
| N | 1223E0200X |
Dentist Specialization: Endodontics |
DEN1000827 | DC | Dental Providers |
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
0401412509 | VA | Dental Providers |
| Street Address |
4660 KENMORE AVE SUITE 700 |
| City | ALEXANDRIA |
| State | VA |
| Zip Code | 22304-1313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841292091 | Lawrence R. Rubin | Internal Medicine | 4660 Kenmore Ave, Ste 1200, Alexandria, VA 22304-1311 | 2005-06-01 |
| 1316403645 | Felicia Cooper | Nurse Practitioner | 4660 Kenmore Ave, Alexandria, VA 22304-1313 | 2019-02-12 |
| 1659812832 | Northern Virginia Laboratory | Clinical Medical Laboratory | 4660 Kenmore Ave, Alexandria, VA 22304-1313 | 2017-03-20 |
| 1023472388 | Dakota Ferrell | Occupational Therapist | 4660 Kenmore Ave, Ste 400, Alexandria, VA 22304-1313 | 2016-04-12 |
| 1194198952 | Stephanie Anne Shaffer | Advanced Practice Midwife | 4660 Kenmore Ave, Suite 902, Alexandria, VA 22304-1313 | 2015-11-02 |
| 1396113270 | Cecelia Brown | Advanced Practice Midwife | 4660 Kenmore Ave, Suite 902, Alexandria, VA 22304-1313 | 2015-09-09 |
| 1437535358 | Kathleen Martin Bell | Nurse Practitioner | 4660 Kenmore Ave, Suite 902, Alexandria, VA 22304-1313 | 2015-08-03 |
| 1760866842 | Kimberly Ann Miller | Nurse Practitioner | 4660 Kenmore Ave, Suite 600, Alexandria, VA 22304-1313 | 2015-07-17 |
| 1649654716 | Nicole Lobo | Physical Therapy Assistant | 4660 Kenmore Ave, Suite 400, Alexandria, VA 22304-1313 | 2015-07-17 |
| 1336522986 | Elise Faith | Midwife | 4660 Kenmore Ave, Suite 902, Alexandria, VA 22304-1313 | 2015-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407489768 | Anthony Michael Frato | Counselor | 205 S Whiting St #601, Alexandria, VA 22304 | 2020-02-14 |
| 1245885805 | Personal Touch Personal Care Providers, LLC | In Home Supportive Care | 4241-d8 Duke Street, Alexandria, VA 22304 | 2019-08-09 |
| 1336658772 | Jade F. Hillery | Doula | 5240 Duke St #310, Alexandria, VA 22304 | 2017-09-28 |
| 1447784731 | Aymara Matos | Behavioral Analyst | 5426 Richenbacher Ave Apt 100, Alexandria, VA 22304 | 2017-04-13 |
| 1659827871 | Tesfaye A Hailemariam Dds PC | Dentist | 5764 Dow Ave, Alexandria, VA 22304 | 2016-08-28 |
| 1912302605 | Alexandria Health Department | Clinic/Center | 1200 North Howard, Alexandria, VA 22304 | 2014-10-24 |
| 1497157663 | Aminata Jalloh | Registered Nurse | 101 South Whiting St, Alexandria, VA 22304 | 2014-09-19 |
| 1386075133 | Carla Renee Riley | Registered Nurse | 4320 Raleigh Ave, Apt 204, Alexandria, VA 22304 | 2013-12-04 |
| 1700223500 | Landmark Dental Care | Dentist | 101 S. Whiting St., Suite 100, Alexandria, VA 22304 | 2013-06-03 |
| 1114266954 | Stella M Meusch | Physician Assistant | 4230 Seminary Rd, Alexandria, VA 22304 | 2013-02-13 |
| Find all providers in zip 22304 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821621467 | Blessed Smiles | Dentist | 5249 Duke St Ste L-10, Alexandria, VA 22304-2926 | 2020-02-21 |
| 1003090234 | David Palmieri | Dentist | 1650 King St Ste 300, Alexandria, VA 22314-2747 | 2007-12-24 |
| 1477746659 | Lawrence M Kotler Dds Ms | Dentist | 3543 West Braddock Rd, Suite E1 Brad Lee Office Building, Alexandria, VA 22301-1903 | 2007-08-22 |
| 1356352702 | Lawrence Mark Kotler | Dentist | 3543 W Braddock Rd, Suite E-1, Alexandria, VA 22302-1903 | 2006-08-11 |
| 1932621943 | Alexandria Endodontics, LLC | Dentist | 1431 Peterman Dr, Alexandria, LA 71301-3433 | 2017-07-11 |
| 1689910556 | Grove Dental Clinic | Dentist | 1707 Osage St, Suite Number 402, Alexandria, VA 22302-2607 | 2012-12-21 |
| 1033365606 | Daniel Goddard Lester | Dentist | 1431 Peterman Dr, Alexandria, LA 71301-3433 | 2008-08-14 |
| 1669483012 | Joel Robert Kessler | Dentist | 3543 W Braddock Rd, Suite E-1, Alexandria, VA 22302-1903 | 2006-08-11 |
| 1568449726 | Loken Mukesh Patel | Dentist | 4660 Kenmore Ave, Suite 700, Alexandria, VA 22304-1313 | 2005-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649898214 | Sally Abdelkarim | Dentist | 556 Garrisonville Rd Ste 200, Stafford, VA 22554-7826 | 2020-07-10 |
| 1225655939 | Avisha Rakesh Shah | Dentist | 3712 Old Forest Rd Ste 100, Lynchburg, VA 24501-6963 | 2020-06-29 |
| 1205307238 | Ideal Endodontics of Woodbridge Pllc | Dentist | 3102 Golansky Blvd Ste 101, Woodbridge, VA 22192-4244 | 2018-12-17 |
| 1154892677 | Prince William Parkway Dental PC | Dentist | 2542 Prince William Pkwy Ste 120, Woodbridge, VA 22192-4149 | 2018-12-10 |
| 1831671353 | Sachin Rastogi Dmd Pllc | Dentist | 6116 Rolling Rd Ste 304, Springfield, VA 22152-1512 | 2018-08-31 |
| 1588143309 | Deepika Ganesh | Dentist | 2601 Swiftrun Rd, Chester, VA 23831-5234 | 2018-08-13 |
| 1134614092 | Specialist Care Endodontics LLC | Dentist | 1964 Gallows Rd Ste 220, Vienna, VA 22182-3814 | 2018-06-24 |
| 1447744131 | Fouad Almalki | Dentist | 1533 Volvo Pkwy, Chesapeake, VA 23320-8489 | 2018-06-18 |
| 1164911863 | Arlington Dental Excellence Specialists Pllc | Dentist | 3801 Fairfax Dr Ste 54, Arlington, VA 22203-1762 | 2018-05-08 |
| 1740790369 | Ashraf Eid | Dentist | 481 Garrisonville Rd Ste 103, Stafford, VA 22554-1601 | 2017-10-10 |
| Find all providers with the same taxonomy | ||||
| City | ALEXANDRIA |
| Zip Code | 22304 |
Please comment or provide details below to improve the information on DR. JESSICA RUSSO REVAND.
| 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.