Provider Demographics
NPI:1467415547
Name:LEVINSON, PHILIP D (DDS)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:D
Last Name:LEVINSON
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 1:2706 MOORES VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-1049
Mailing Address - Country:US
Mailing Address - Phone:410-653-3513
Mailing Address - Fax:410-642-1180
Practice Address - Street 1:DENTAL SERVICE 160
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:PERRY POINT
Practice Address - State:MD
Practice Address - Zip Code:21902
Practice Address - Country:US
Practice Address - Phone:410-642-1010
Practice Address - Fax:410-642-1180
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD51071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice