DR. LUKE WILLIAM REVELT (NPI# 1669088381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669088381 |
| Entity Type | Individual |
| Full Name | DR. LUKE WILLIAM REVELT |
| Credential | DMD |
| Practice Address |
2800 College Ave Alton IL 62002-4742 |
| Mailing Address |
4 Azalea Ct Edwardsville IL 62025-3999 |
| Practice Telephone | 6184747000 |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019032795 | IL | Dental Providers |
| Street Address |
2800 COLLEGE AVE |
| City | ALTON |
| State | IL |
| Zip Code | 62002-4742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215912696 | Southern Illinois University Edwardsville School of Dental Medicine | Dentist | 2800 College Ave, Alton, IL 62002-4700 | 2005-12-08 |
| 1699382333 | Matthew Feigenbaum | Dentist | 2800 College Ave, Alton, IL 62002-4700 | 2020-09-27 |
| 1013528801 | Teniola Omopariola | Dentist | 2800 College Ave, Alton, IL 62002-4742 | 2020-08-14 |
| 1285243170 | Michelle Hickey | Dentist | 2800 College Ave, Alton, IL 62002-4742 | 2020-07-27 |
| 1821607839 | Sogol H Biroon | Dentist | 2800 College Ave, Alton, IL 62002-4742 | 2020-07-26 |
| 1912530924 | Ioannis Gkikas | Dentist | 2800 College Ave, Alton, IL 62002-4742 | 2020-02-18 |
| 1942859509 | James Joseph Cahill | Dentist | 2800 College Ave, Alton, IL 62002-4700 | 2019-09-06 |
| 1023677218 | Lucas Winebaugh | Dentist | 2800 College Ave, Alton, IL 62002-4742 | 2019-06-11 |
| 1528552296 | Katherine Sue Hanser | Dentist | 2800 College Ave, Alton, IL 62002-4742 | 2018-06-18 |
| 1184118044 | Brittany Erin Pham | Dentist | 2800 College Ave, Alton, IL 62002-4742 | 2018-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285272807 | Jersey Community Hospital | Obstetrics & Gynecology | #2 Memorial Drive, Suite 203, Alton, IL 62002 | 2019-12-13 |
| 1912540659 | Kelsi N Harre | Community Health Worker | 2603 N. Rogers Ave., Alton, IL 62002 | 2019-10-25 |
| 1841848322 | Destiny L Miller | Technician | 3429 Meridocia St, Alton, IL 62002 | 2019-08-28 |
| 1942854633 | Jessica Leigh Jump | Speech-Language Pathologist | 453 Bluff Street, Alton, IL 62002 | 2019-07-30 |
| 1194380741 | Vasiliki Kytridou | Dentist | 2800 College Avenue Southern Il University School of De, Building 285, Alton, IL 62002 | 2019-05-08 |
| 1982125910 | Amy Nicole Spalding | Social Worker | 1123 Harrison St, Alton, IL 62002 | 2017-06-29 |
| 1962856310 | Patricia Gregory | Social Worker | 5090 Humbert Rd, Alton, IL 62002 | 2016-04-21 |
| 1447612510 | Alanna Lynn Mcnelly | Chiropractor | 219 Piasa St, Suite 200, Alton, IL 62002 | 2016-03-28 |
| 1174983050 | Roberta's Lovely Ladies Boutique | Mastectomy Fitter | 603 W. Delmar, Alton, IL 62002 | 2016-03-04 |
| 1184081556 | Darcy Graham | Nurse Practitioner | 4 Memorial Dr # 210, Alton, IL 62002 | 2016-01-15 |
| Find all providers in zip 62002 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336679521 | Mikal Ismail Bell | Dentist | 1809 Homer Adams Pkwy Ste A, Alton, IL 62002-5606 | 2017-06-19 |
| 1033550785 | Martin F. Land | Dentist | 2800 College Ave - Bldg. 263, Southern Illinois University, School of Dental Medicine, Alton, IL 62002-4700 | 2013-07-10 |
| 1639421951 | Sscl Corp Pllc | Dentist | 1315 W. Main Ave Ste 10, Alton, TX 78573 | 2012-10-10 |
| 1457633851 | Brian Ernest Waldman | Dentist | 1410 Seminary St, Alton, IL 62002-4040 | 2011-09-13 |
| 1093018426 | Yojin Steven Chon | Dentist | 1315 W Main Ave Ste 10, Alton, TX 78573-1643 | 2010-12-07 |
| 1962614479 | James J. Reinersman D.m.d. P.C. | Dentist | 2524 State St, Alton, IL 62002-5148 | 2007-05-04 |
| 1447472790 | Dental Professionals of Illinois, P.C. | Dentist | 3430 College Avenue, Alton, IL 62002 | 2007-05-03 |
| 1467674002 | Affordable Dentistry Today, PC | Dentist | 3432 College Avenue, Alton, IL 62002 | 2007-05-03 |
| 1427185503 | Roy Dale Bower | Dentist | 2716 Corner Ct, Alton, IL 62002-5328 | 2007-02-27 |
| 1710037155 | James Edson Nativi | Dentist | 2418 Bloomer Dr, Alton, IL 62002-4809 | 2007-01-10 |
| Find all providers in ALTON | ||||
Please comment or provide details below to improve the information on DR. LUKE WILLIAM REVELT.
| 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.