Healthcare Provider Details

I. General information

NPI: 1578771614
Provider Name (Legal Business Name): DANIEL E. LEVIN, DDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 05/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7891 TALBERT AVE SUITE 101
HUNTINGTON BEACH CA
92648-1319
US

IV. Provider business mailing address

7891 TALBERT AVE SUITE 101
HUNTINGTON BEACH CA
92648-1319
US

V. Phone/Fax

Practice location:
  • Phone: 714-842-2521
  • Fax: 714-842-1083
Mailing address:
  • Phone: 714-842-2521
  • Fax: 714-842-1083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberD25001
License Number StateCA

VIII. Authorized Official

Name: DANIEL ERIC LEVIN
Title or Position: CEO
Credential: DDS
Phone: 714-842-2521