Provider Demographics
NPI:1366686669
Name:DIELEMAN-LEVINE, RUTH PETRA ANTOINETTE (DDS)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:PETRA ANTOINETTE
Last Name:DIELEMAN-LEVINE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:550 MAMARONECK AVENUE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528
Mailing Address - Country:US
Mailing Address - Phone:646-483-5591
Mailing Address - Fax:212-898-9027
Practice Address - Street 1:550 MAMARONECK AVENUE
Practice Address - Street 2:SUITE 110
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528
Practice Address - Country:US
Practice Address - Phone:646-483-5591
Practice Address - Fax:212-898-9027
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0541491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice