Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Revive Dentistry, PLLC

Organization Dental Clinic/Center · NPI 1023975547

Revive Dentistry, PLLC is a Dental Clinic/Center in Orange City, Florida. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

272 E Graves Ave
Orange City, FL 32763-5269
Phone: (386) 775-4300
Fax: (386) 775-0630
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X

Record details

NPI number1023975547
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Omid Khezri — Dentist · (765) 631-0659
NPI enumeratedJanuary 7, 2026
Last updated in NPPESJanuary 7, 2026
Certification dateJanuary 6, 2026
Mailing address272 E Graves Ave, Orange City, FL 32763-5269

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