Provider Demographics
NPI:1952450470
Name:LEVINE, JANET SUSAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:SUSAN
Last Name:LEVINE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SOUTH BROADWAY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591
Mailing Address - Country:US
Mailing Address - Phone:914-631-4355
Mailing Address - Fax:914-631-4866
Practice Address - Street 1:200 SOUTH BROADWAY
Practice Address - Street 2:SUITE 210
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591
Practice Address - Country:US
Practice Address - Phone:914-631-4355
Practice Address - Fax:914-631-4866
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY38103122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist