Provider Demographics
NPI:1952765992
Name:LEVY, KATERINA (DDS)
Entity Type:Individual
Prefix:
First Name:KATERINA
Middle Name:
Last Name:LEVY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6837 YELLOWSTONE BLVD APT D64
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3416
Mailing Address - Country:US
Mailing Address - Phone:347-536-7273
Mailing Address - Fax:
Practice Address - Street 1:140 DE KRUIF PL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-2201
Practice Address - Country:US
Practice Address - Phone:718-379-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY059270122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist