Provider Demographics
NPI:1215203104
Name:LEVI, LAUREN ELIZABETH (DMD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:LEVI
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 1:19 SKYLINE DRIVE
Mailing Address - Street 2:FACULTY PRACTICE COMPLEX CLINIC
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532
Mailing Address - Country:US
Mailing Address - Phone:914-862-7313
Mailing Address - Fax:914-594-2681
Practice Address - Street 1:19 SKYLINE DRIVE
Practice Address - Street 2:FACULTY PRACTICE COMPLEX CLINIC
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-0100
Practice Address - Country:US
Practice Address - Phone:914-862-7313
Practice Address - Fax:914-594-2681
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0567291223X2210X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X2210XDental ProvidersDentistOrofacial Pain
No122300000XDental ProvidersDentist