Provider Demographics
NPI:1952721169
Name:MARK LEVY DDS INC
Entity Type:Organization
Organization Name:MARK LEVY DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-777-7350
Mailing Address - Street 1:1335 DUBLIN RD STE 100B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-1000
Mailing Address - Country:US
Mailing Address - Phone:614-777-7350
Mailing Address - Fax:888-390-0424
Practice Address - Street 1:1335 DUBLIN RD STE 100B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-1000
Practice Address - Country:US
Practice Address - Phone:614-777-7350
Practice Address - Fax:888-390-0424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-27
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH16150261QD0000X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental