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

Revive Periodontics and Implants

Organization Dental Clinic/Center · NPI 1619722857

Revive Periodontics and Implants is a Dental Clinic/Center in Burnsville, Minnesota. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

625 E Nicollet Blvd Ste 330
Burnsville, MN 55337-6736
Phone: (952) 435-0333
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 number1619722857
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Andrew Glover — President · (651) 334-2190
NPI enumeratedApril 22, 2024
Last updated in NPPESApril 22, 2024
Certification dateApril 22, 2024
Mailing address625 E Nicollet Blvd Ste 330, Burnsville, MN 55337-6736

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