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NPI Code Detail

MEDICARE: DR. JOHN ALAN LEVON D.D.S

MEDICARE: DR. JOHN ALAN LEVON D.D.S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0700XProsthodontics12007629IN

General Provider Information

NPI Number : 1215094628
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN ALAN LEVON D.D.S
Provider Business Mailing Address
First Line : 7240 CREEKWOOD CT
Second Line :
City : PITTSBORO
State : IN
Zip : 46167-9108
Country : US
Telephone Number : 317-274-5628
Fax Number : 317-274-6583
Provider Business Practice Location Address
First Line : 1121 W MICHIGAN ST
Second Line : IU SCHOOL OF DENTISTRY, ROOM 286B
City : INDIANAPOLIS
State : IN
Zip : 46202-5211
Country : US
Telephone Number : 317-274-5628
Fax Number : 317-274-6583
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 07/08/2007

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