Provider Demographics
NPI:1891713566
Name:SOLAK, LEVON (DDS)
Entity Type:Individual
Prefix:
First Name:LEVON
Middle Name:
Last Name:SOLAK
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 1:525 S OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-1006
Mailing Address - Country:US
Mailing Address - Phone:213-624-3333
Mailing Address - Fax:213-624-3345
Practice Address - Street 1:525 S OLIVE ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-1006
Practice Address - Country:US
Practice Address - Phone:213-624-3333
Practice Address - Fax:213-624-3345
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA445421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice