Active NPI
Carly Levine, D.D.S.
- General Practice Dentistry
- Pacific Palisades, CA
National Provider Identifier
1609008812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 58507
- Practice address
- 881 Alma Real Dr
Suite T2
Pacific Palisades, CA 90272-3731 - Phone
- (310) 459-2303
- Fax
- (310) 459-0015
- NPI assigned
- Aug 20, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 58507 | CA | Primary |
Addresses
Primary practice location
881 Alma Real Dr
Suite T2
Pacific Palisades, CA 90272-3731
Mailing address
881 Alma Real Dr
Suite T2
Pacific Palisades, CA 90272-3731
Phone (310) 459-2303
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58507 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cerisa Moncayo D.D.S. Dental Corporation | Past | Accepting new patients | |
| Dr. William Francis D.D.S. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba The Palisades Dentists
- Dentist
- Pacific Palisades, CA
- NPI 1134653256
-
- Dental Clinic/Center
- Pacific Palisades, CA
- NPI 1952584096
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451433600000",
"number": "1609008812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "881 ALMA REAL DR",
"address_2": "SUITE T2",
"city": "PACIFIC PALISADES",
"state": "CA",
"postal_code": "902723731",
"telephone_number": "310-459-2303",
"fax_number": "310-459-0015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "881 ALMA REAL DR",
"address_2": "SUITE T2",
"city": "PACIFIC PALISADES",
"state": "CA",
"postal_code": "902723731",
"telephone_number": "310-459-2303",
"fax_number": "310-459-0015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVINE",
"first_name": "CARLY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-20",
"last_updated": "2015-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "58507",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pacific Palisades, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.