Provider Demographics
NPI:1497883052
Name:LEVIN, LINDA GIBSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:GIBSON
Last Name:LEVIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 WESTCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5071
Mailing Address - Country:US
Mailing Address - Phone:919-493-7255
Mailing Address - Fax:
Practice Address - Street 1:3624 SHANNON RD
Practice Address - Street 2:SUITE 106
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3772
Practice Address - Country:US
Practice Address - Phone:919-401-4827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC51451223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics