Provider Demographics
NPI:1184962425
Name:DUNLEVY, HARRY A (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:HARRY
Middle Name:A
Last Name:DUNLEVY
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:DR
Other - First Name:JACK
Other - Middle Name:
Other - Last Name:DUNLEVY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11601 ROBIOUS RD STE 130
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-5605
Mailing Address - Country:US
Mailing Address - Phone:804-794-3498
Mailing Address - Fax:804-794-8344
Practice Address - Street 1:11601 ROBIOUS RD STE 130
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-5605
Practice Address - Country:US
Practice Address - Phone:804-794-3498
Practice Address - Fax:804-794-8344
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010069071223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics