Individual provider Active NPI

Mitchell Evan Levy, DDS

  • General Practice Dentistry
  • Lynbrook, NY
National Provider Identifier
1477563914
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
040091 Issued in NY
Practice address
212 Hempstead Ave
Lynbrook, NY 11563-1611
Phone
(516) 599-5880
Fax
(516) 599-7128
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 040091 NY
General Practice Dentistry 1223G0001X 040091 NY Primary

Addresses

Primary practice location

212 Hempstead Ave
Lynbrook, NY 11563-1611

Mailing address

212 Hempstead Ave
Lynbrook, NY 11563-1611
Phone (516) 599-5880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20151103000892 NY Order and Referring Only - DentistPractitioner - Dentist 4789994757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ab & GB Dental, P.C. PastSince Feb 4, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1477563914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 HEMPSTEAD AVE",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115631611",
            "telephone_number": "516-599-5880",
            "fax_number": "516-599-7128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 HEMPSTEAD AVE",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115631611",
            "telephone_number": "516-599-5880",
            "fax_number": "516-599-7128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVY",
        "first_name": "MITCHELL",
        "middle_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "040091",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "040091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynbrook, NY

Sources for this page

Verify at the official NPI Registry.