Provider Demographics
NPI:1811918303
Name:LEVIN, RONALD L (DMD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:L
Last Name:LEVIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26910 GRAND CENTRAL PKWY APT 17L
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11005-1017
Mailing Address - Country:US
Mailing Address - Phone:516-410-3277
Mailing Address - Fax:
Practice Address - Street 1:26910 GRAND CENTRAL PKWY APT 17L
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11005-1017
Practice Address - Country:US
Practice Address - Phone:516-410-3277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0295411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice