Active NPI
Robert L Levine, DMD
- Dentist
- San Diego, CA
National Provider Identifier
1609060672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 39678
- Practice address
- 4453 Clairemont Mesa Blvd
San Diego, CA 92117 - Phone
- (858) 274-2500
- Fax
- (858) 274-2522
- NPI assigned
- Aug 31, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 39678 | CA | Primary |
| General Practice Dentistry | 1223G0001X | 39678 | CA |
Addresses
Primary practice location
4453 Clairemont Mesa Blvd
San Diego, CA 92117
Mailing address
8861 Villa Jolla Dr
Ste 501
La Jolla, CA 92037
Phone (858) 455-7200
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 |
|---|---|---|---|
| 39678 | CA | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191456000000",
"number": "1609060672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8861 VILLA JOLLA DR",
"address_2": "STE 501",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "92037",
"telephone_number": "858-455-7200",
"fax_number": "858-455-7205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4453 CLAIREMONT MESA BLVD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92117",
"telephone_number": "858-274-2500",
"fax_number": "858-274-2522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVINE",
"first_name": "ROBERT",
"middle_name": "L",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-31",
"last_updated": "2007-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "39678",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "39678",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.