Provider Demographics
NPI:1265531032
Name:LEWIS J. LEVITAN DDS, INC.
Entity type:Organization
Organization Name:LEWIS J. LEVITAN DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:LEVITAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-349-8043
Mailing Address - Street 1:7300 BLANCO RD
Mailing Address - Street 2:# 402
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-4936
Mailing Address - Country:US
Mailing Address - Phone:210-349-8043
Mailing Address - Fax:210-349-8318
Practice Address - Street 1:7300 BLANCO RD
Practice Address - Street 2:# 402
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-4936
Practice Address - Country:US
Practice Address - Phone:210-349-8043
Practice Address - Fax:210-349-8318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty