Revere Dental
Revere Dental is a healthcare organization registered as Dental Clinic/Center in Bourbonnais, IL, holding Type 2 (organization) NPI 1790479210 since 2023. The authorized official on file is Peter Girgis, Dentist.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1790479210 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Revere Dental |
| Practice address | 588 WILLIAM LATHAM DR STE 2, Bourbonnais, IL, 60914 |
| Phone | 8159336100 |
| Enumeration date | 2023-06-07 |
| Last updated in NPPES | 2023-06-07 |
Authorized official
| Name | Peter Girgis |
|---|---|
| Title | Dentist |
| Phone | 8159336100 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QD0000X | Dental Clinic/Center | Primary | — | — |
Copy-ready billing details
Provider: Revere Dental NPI: 1790479210 Taxonomy: 261QD0000X (Dental Clinic/Center) Address: 588 WILLIAM LATHAM DR STE 2, Bourbonnais, IL, 60914
Verify this record
Cross-check NPI 1790479210 against the authoritative CMS record: view Revere Dental on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is the NPI number for Revere Dental?
Who is the authorized official for Revere Dental?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2023-06-07.