Provider Demographics
NPI:1205033164
Name:LEVIN, BERNARD GAR (DDS, MDS)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:GAR
Last Name:LEVIN
Suffix:
Gender:F
Credentials:DDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3053 MOTOR AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-4732
Mailing Address - Country:US
Mailing Address - Phone:310-837-6266
Mailing Address - Fax:310-837-6266
Practice Address - Street 1:11645 WILSHIRE BLVD
Practice Address - Street 2:SUITE 900
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1708
Practice Address - Country:US
Practice Address - Phone:310-442-9188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA200701223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery