Provider Demographics
NPI:1407973274
Name:LEVENTER, MARVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:
Last Name:LEVENTER
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 1:650 W BALTIMORE ST STE 5201
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1510
Mailing Address - Country:US
Mailing Address - Phone:410-706-2470
Mailing Address - Fax:410-706-4031
Practice Address - Street 1:650 W BALTIMORE ST RM 5201
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1510
Practice Address - Country:US
Practice Address - Phone:410-706-5806
Practice Address - Fax:410-706-3028
Is Sole Proprietor?:No
Enumeration Date:2007-03-25
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD117031223D0004X, 1223G0001X
PADS028893L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223D0004XDental ProvidersDentistDentist Anesthesiologist