Mannie Levi, DDS

Individual provider Active NPI Pediatric Dentistry · Upper Montclair, NJ

NPI 1487729570 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1487729570
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Dentistry 1223P0221X
License
DI12716 (NJ)
Practice address
204 Bellevue Ave
Upper Montclair, NJ 07043-1893
Phone
(973) 783-4491
Fax
(973) 783-5286
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DI12716NJMDPediatric Dentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DI12716 NJ Yes

Addresses

Primary practice location

204 Bellevue Ave
Upper Montclair, NJ 07043-1893

Mailing address

204 Bellevue Ave
Upper Montclair, NJ 07043-1893
Phone (973) 783-4491

Other providers in Upper Montclair, NJ

All providers in Upper Montclair, NJ · Pediatric Dentistry in New Jersey

Sources for this page

Verify at the official NPI Registry.