Provider Demographics
NPI:1790337673
Name:LEVO DENTAL PLLC
Entity Type:Organization
Organization Name:LEVO DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:TUAN ANH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-678-1493
Mailing Address - Street 1:14392 BROADWINGED DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-5928
Mailing Address - Country:US
Mailing Address - Phone:703-678-1493
Mailing Address - Fax:
Practice Address - Street 1:113 E UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-6828
Practice Address - Country:US
Practice Address - Phone:703-678-1493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1811346042OtherNPPES
TX1407408354OtherNPPE