Provider Demographics
NPI:1548462476
Name:LEVIN, JEFFREY ADAM (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ADAM
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 1:317 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084-1313
Mailing Address - Country:US
Mailing Address - Phone:856-627-9200
Mailing Address - Fax:856-346-9511
Practice Address - Street 1:317 UNION AVE
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1313
Practice Address - Country:US
Practice Address - Phone:856-627-9200
Practice Address - Fax:856-346-9511
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0179071223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics