Provider Demographics
NPI:1316382641
Name:LEVINTOV, NIKOLAY (MD, DDS)
Entity Type:Individual
Prefix:DR
First Name:NIKOLAY
Middle Name:
Last Name:LEVINTOV
Suffix:
Gender:M
Credentials:MD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CANDLEWOOD CMNS
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-2168
Mailing Address - Country:US
Mailing Address - Phone:732-364-0400
Mailing Address - Fax:732-364-3336
Practice Address - Street 1:100 CANDLEWOOD CMNS
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-2168
Practice Address - Country:US
Practice Address - Phone:732-364-0400
Practice Address - Fax:732-364-3336
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10398300204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery