Levi Michael Upham, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DS044755 Issued in PA

Practice address

1111 E End Blvd
Wilkes Barre, PA 18711-0030

Phone

(570) 824-3521

NPI assigned

Jun 2, 2025

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dentist

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Penn Comprehensive Health Services

  dba Laurel Health Center

  • Federally Qualified Health Center (FQHC)
  • Wellsboro, PA
  • NPI 1912093576
  Medicare reassignment NPD
• North Penn Comprehensive Health Services

  dba Sullivan County Laurel Health Center

  • Federally Qualified Health Center (FQHC)
  • Laporte, PA
  • NPI 1093520587
  NPD
• North Penn Comprehensive Health Services

  dba Mansfield Laurel Health Center

  • Federally Qualified Health Center (FQHC)
  • Mansfield, PA
  • NPI 1750461455
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1174416564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E END BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110030",
            "telephone_number": "570-824-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E END BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110030",
            "telephone_number": "570-824-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPHAM",
        "first_name": "LEVI",
        "middle_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS044755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Luke Ulshafer
• Uma Disability Center (uma home health services inc.)
• Muhammad Umair
• United Rehabilitation Services, Inc.
• Sangnya Upadhyaya
• Shweta Uppal, M.D.
• Daniel William Upton, M.D.
• Jennifer Marie Urban, LPN
• Usv Optical Inc.
• V-Pharm Inc (Keystone Professional Pharmacy)

• Dentist in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.