Individual provider Active NPI

Laurence Kent Levy, DMD

  • General Practice Dentistry
  • Middletown, CT
National Provider Identifier
1619018488
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
007725 Issued in CT
Practice address
193 Main St
Middletown, CT 06457-3423
Phone
(860) 347-4500
Fax
(860) 347-5802
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 007725 CT Primary

Addresses

Primary practice location

193 Main St
Middletown, CT 06457-3423

Mailing address

193 Main St
Middletown, CT 06457-3423
Phone (860) 347-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20150521001758 CT Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 2163742743

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7725CTMDSpeech-Language Pathologist
007725CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lou Ann Baylock,LLC PastSince Aug 24, 2009 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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619018488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573423",
            "telephone_number": "860-347-4500",
            "fax_number": "860-347-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573423",
            "telephone_number": "860-347-4500",
            "fax_number": "860-347-5802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVY",
        "first_name": "LAURENCE",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "007725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.