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Deactivated NPI 1871673632 Deactivated / Inactive NPI Male Practitioner

Dr. Edward D Revels , DDS

Dentist - General Practice • De Queen, AR

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Edward Revels has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 16, 2006
NPI Deactivation Date July 17, 2020
Total Practice Duration ~14 Years of Practice (2006 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Edward Revels, DDS was a registered Dentist - General Practice practicing in De Queen, AR. Throughout an active medical career spanning 14 years, Dr. Revels provided care at the practice location at 1316 W COLLIN RAYE DR until profile deactivation on 2020-07-17.

Practice Location & Contact Primary Location

Practice Address

1316 W Collin Raye Dr

De Queen, AR 718322135

Telephone 8705843212
Fax 8706486846
Associated Practice Facility / Clinic
🏢 Mark R. Stewart, Dmd, Inc. Facility NPI 1144346750

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in De Queen, AR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 25.0 Yrs
Regional Practice Density
4 Specialists

Practicing in De Queen, AR (909 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License AR AR1679

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Mark Stewart , DMD

Dentist - General Practice

NPI 1063449528

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 17, 2020

Record deactivated on July 17, 2020

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1316 W COLLIN RAYE DR, DE QUEEN, AR 718322135 (Tel: 8705843212)

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Updated Business Mailing Address July 08, 2007

Registered at 1316 W COLLIN RAYE DR, DE QUEEN, AR 718322135 (Tel: 8705843212)

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Provider Name / Credentials Updated July 08, 2007

Recorded as EDWARD REVELS, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #AR1679 in AR)

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Initial NPI Registration & Enumeration October 16, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1871673632
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 16, 2006
Last Update: July 08, 2007
Deactivation Date: July 17, 2020

Mailing Address

1316 W Collin Raye Dr

De Queen, AR 718322135

Phone: 8705843212

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.