Provider Demographics
NPI:1467504258
Name:LEVIN, ROBERT IRWIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:IRWIN
Last Name:LEVIN
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 1:18800 DELAWARE ST
Mailing Address - Street 2:600
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1959
Mailing Address - Country:US
Mailing Address - Phone:714-841-0264
Mailing Address - Fax:714-841-0526
Practice Address - Street 1:18800 DELAWARE ST
Practice Address - Street 2:600
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1959
Practice Address - Country:US
Practice Address - Phone:714-841-0264
Practice Address - Fax:714-841-0526
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice