Bradley David Revenis, DDS
NPI 1609385368ActiveIndividual· Dentist· Fallon, NV
Dentist (DDS) in Fallon, Nevada, licensed in AZ, with an NPI issued in September 2017.
Overview
| NPI | 1609385368 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DDS |
| Sole proprietor | Yes |
| NPI issued | Sep 26, 2017 |
| Last updated in NPPES | Jul 10, 2026 |
| Certified by provider | Jul 10, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | 9872 | AZ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
Other Dentist providers in Fallon
- 1801223540
- 1477242204
- 1801449160
- 1811101918
- 1104428333
- 1699401257
- 1205120524