NPI 1982561718

Smile Revival LLC

Organisation General Practice Dentistry Berea, KY

Practice location

Address: 178 Mini Mall Dr, Berea, KY 40403-1170
Phone: (859) 231-0596
Mailing address: 105 Spruce St, Lexington, KY 40507-2109

Authorised official

Name: Andrew White
Title: Sole Manager
Phone: (859) 810-8320

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X

Other Dentist providers in Kentucky →

Registry record

NPI: 1982561718
Entity type: Organization
NPI issued: 5 Jan 2026
Record last updated: 13 Apr 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.