Healthcare Provider Details

I. General information

NPI: 1083956452
Provider Name (Legal Business Name): ARIEL LEVY D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2013
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57198 10 MILE RD
SOUTH LYON MI
48178-8327
US

IV. Provider business mailing address

57198 10 MILE RD
SOUTH LYON MI
48178-8327
US

V. Phone/Fax

Practice location:
  • Phone: 248-437-3377
  • Fax: 248-403-8551
Mailing address:
  • Phone: 248-437-3377
  • Fax: 248-403-8551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number2901601653
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: