MEDICARE: MRS. SHANNON K REVELEY DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	13800	MD

General Provider Information

NPI Number	:	1134565328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHANNON K REVELEY DDS

Provider Business Mailing Address
First Line	:	43 JONES FALLS TER
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21209-1684
Country	:	US
Telephone Number	:	443-622-9276
Fax Number	:

Provider Business Practice Location Address
First Line	:	1811 CRAIN HWY S STE A
Second Line	:
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-5561
Country	:	US
Telephone Number	:	410-760-4455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2013
Last Update Date	:	02/23/2026

Similar Medicare Providers

1699901157 — DR. EUGENE HUANG DDS
Practice Location Address:

1811 CRAIN HWY S STE A
GLEN BURNIE, MD
21061-5561

Practice Phone: 410-760-4455
Practice Fax:

1023448305 — SAMER SAIEDY MD GB LLC
Practice Location Address:

1811 CRAIN HWY S
GLEN BURNIE, MD
21061-5561

Practice Phone: 443-761-6630
Practice Fax: 470-768-1571

1588417976 — SAMER SAIEDY MD PA
Practice Location Address:

1811 CRAIN HWY S STE C
GLEN BURNIE, MD
21061-5561

Practice Phone: 443-761-6630
Practice Fax: 410-768-1571

1104770783 — UNIVERSITY OF MARYLAND PHYSICIANS P.A.
Practice Location Address:

255 HOSPITAL DR FL 3
GLEN BURNIE, MD
21061-6356

Practice Phone: 410-553-8240
Practice Fax: 410-553-8239

1396600599 — KINGSLEY MASALLA BABILA NP
Practice Location Address:

301 HOSPITAL DR
GLEN BURNIE, MD
21061-5803

Practice Phone: 202-308-3520
Practice Fax:

1114241452 — DR. SAMAN SOURI D.M.D
Practice Location Address:

300 HOSPITAL DR STE 237
GLEN BURNIE, MD
21061-5856

Practice Phone: 410-761-4684
Practice Fax: 410-888-7086

Directions to “ MRS. SHANNON K REVELEY DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.