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General NPI Number Information
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NPI Number | 1811346042
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Entity Type | Individual
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Provider Name | TUAN ANH LEVO
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Gender | Male
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Dates
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Enumeration Date | 06/08/2016
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Last Update Date | 07/11/2019
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Provider Practice Location Address
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Address Line | 113 E UNIVERSITY AVE
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City | GEORGETOWN
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State | TX
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Zip | 78626-6828
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Country | US
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Telephone | 703-678-1493
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Fax |
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Provider Business Mailing Address
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Address Line | 14392 BROADWINGED DR
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City | GAINESVILLE
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State | VA
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Zip | 20155-5928
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401415235
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 34947
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License Number State | TX
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