Provider Demographics
NPI:1972756468
Name:MARTI LEVINSON, DDS, PLLC
Entity Type:Organization
Organization Name:MARTI LEVINSON, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTI
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:LEVINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-406-2156
Mailing Address - Street 1:7134 S YALE AVE
Mailing Address - Street 2:STE 150
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-6372
Mailing Address - Country:US
Mailing Address - Phone:918-496-1358
Mailing Address - Fax:918-494-0681
Practice Address - Street 1:7134 S YALE AVE
Practice Address - Street 2:STE 150
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-6372
Practice Address - Country:US
Practice Address - Phone:918-496-1358
Practice Address - Fax:918-494-0681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK58711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty