Healthcare Provider Details

I. General information

NPI: 1265026173
Provider Name (Legal Business Name): DENNIS LEVY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2021
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 BERGEN ST
NEWARK NJ
07103-2496
US

IV. Provider business mailing address

200 ANGELO CIFELLI DR APT 341
HARRISON NJ
07029-3220
US

V. Phone/Fax

Practice location:
  • Phone: 201-556-8649
  • Fax: 973-972-3070
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI03084300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: