Provider Demographics
NPI:1285644732
Name:LEVIN, DANIEL E (DDS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:LEVIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7891 TALBERT AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:HUNTINGTON BCH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-8613
Mailing Address - Country:US
Mailing Address - Phone:714-842-2521
Mailing Address - Fax:714-842-1083
Practice Address - Street 1:7891 TALBERT AVE
Practice Address - Street 2:STE 101
Practice Address - City:HUNTINGTON BCH
Practice Address - State:CA
Practice Address - Zip Code:92648-8613
Practice Address - Country:US
Practice Address - Phone:714-842-2521
Practice Address - Fax:714-842-1083
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD250011223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
D25001Medicare UPIN