Provider Demographics
NPI:1861650749
Name:DEXTER S LEVY M D P C
Entity Type:Organization
Organization Name:DEXTER S LEVY M D P C
Other - Org Name:SOUTHWEST FAMILY PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEXTER
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:M D P C
Authorized Official - Phone:303-972-2727
Mailing Address - Street 1:8966 W BOWLES AVE
Mailing Address - Street 2:#L
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-8613
Mailing Address - Country:US
Mailing Address - Phone:303-972-2727
Mailing Address - Fax:303-972-8652
Practice Address - Street 1:8966 W BOWLES AVE
Practice Address - Street 2:#L
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-8613
Practice Address - Country:US
Practice Address - Phone:303-972-2727
Practice Address - Fax:303-972-8652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO309171100000X
CO19855173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC88304Medicare PIN
COE22405Medicare UPIN