Provider Demographics
NPI:1164951224
Name:LEVINE, BENJAMIN ADAM (DMD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:ADAM
Last Name:LEVINE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4139 BROWNSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-3306
Mailing Address - Country:US
Mailing Address - Phone:412-881-1320
Mailing Address - Fax:
Practice Address - Street 1:4139 BROWNSVILLE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15227-3306
Practice Address - Country:US
Practice Address - Phone:412-881-1320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0413421223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics