Healthcare Provider Details

I. General information

NPI: 1821125717
Provider Name (Legal Business Name): LEVITIN DENTAL CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 08/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3938 SPRINGFIELD RD
GLEN ALLEN VA
23060-4119
US

IV. Provider business mailing address

3938 SPRINGFIELD RD
GLEN ALLEN VA
23060-4119
US

V. Phone/Fax

Practice location:
  • Phone: 804-747-7400
  • Fax: 804-747-7096
Mailing address:
  • Phone: 804-747-7400
  • Fax: 804-747-7096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DONALD GARY LEVITIN
Title or Position: PRESIDENT
Credential: DDS
Phone: 804-747-7400