Provider Demographics
NPI:1225253602
Name:LEVANDOSKI, RONALD R (DMD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:R
Last Name:LEVANDOSKI
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 1:11001 ARBOR PINE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144
Mailing Address - Country:US
Mailing Address - Phone:702-310-5970
Mailing Address - Fax:702-310-5973
Practice Address - Street 1:7975 WEST SAHARA AVE
Practice Address - Street 2:#102
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117
Practice Address - Country:US
Practice Address - Phone:702-310-5970
Practice Address - Fax:702-310-5973
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3584122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist