Provider Demographics
NPI:1144584103
Name:LEVY, KAREEN ALBERTA (DMD)
Entity Type:Individual
Prefix:DR
First Name:KAREEN
Middle Name:ALBERTA
Last Name:LEVY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3614 BAINBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-2242
Mailing Address - Country:US
Mailing Address - Phone:216-832-8994
Mailing Address - Fax:
Practice Address - Street 1:4324 TUSCARAWAS ST W
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-5427
Practice Address - Country:US
Practice Address - Phone:330-478-4780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0236761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice