Provider Demographics
NPI:1407249725
Name:LEVIN, ZACHARY JOSEPH (DMD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:JOSEPH
Last Name:LEVIN
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 1:1229 JOHNSON FERRY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-2778
Mailing Address - Country:US
Mailing Address - Phone:770-952-5255
Mailing Address - Fax:770-952-5242
Practice Address - Street 1:1229 JOHNSON FERRY RD STE 100
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-2778
Practice Address - Country:US
Practice Address - Phone:770-952-5255
Practice Address - Fax:770-952-5242
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN207471223X0400X
GADN0151271223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDN20747OtherFLORIDA DEPARTMENT OF HEALTH