MEDICARE: STANLEY M. LEVENSON, DMD,P.C

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
1	261QD0000X	Dental Clinic/Center	16437	MA

General Provider Information

NPI Number	:	1437327368
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STANLEY M. LEVENSON, DMD,P.C

Provider Business Mailing Address
First Line	:	9 LINDEN ST STE 1
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01609-3243
Country	:	US
Telephone Number	:	508-753-3105
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 LINDEN ST
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01609-2510
Country	:	US
Telephone Number	:	508-753-3105
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STANLEY MARK LEVENSON
Credential	:	DMD, PC
Telephone Number	:	508-753-3105

Provider Enumeration Date	:	02/13/2008
Last Update Date	:	03/24/2025

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