Provider Demographics
NPI:1881799781
Name:LEWIN, ROGER S (DDS)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:S
Last Name:LEWIN
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 1:9101 CHERRY LN
Mailing Address - Street 2:STE 106
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20070
Mailing Address - Country:US
Mailing Address - Phone:301-725-3418
Mailing Address - Fax:301-725-2306
Practice Address - Street 1:9101 CHERRY LN
Practice Address - Street 2:STE 106
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20070
Practice Address - Country:US
Practice Address - Phone:301-725-3418
Practice Address - Fax:301-725-2306
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6423122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist