Individual provider Active NPI

Ira S Levenson, D.D.S., M.S.

  • Periodontics
  • Washington Court House, OH
National Provider Identifier
1902818479
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
30018442 Issued in OH
Practice address
1502 Columbus Ave
Washington Court House, OH 43160-1767
Phone
(740) 335-8877
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

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
Periodontics 1223P0300X 30018442 OH Primary

Addresses

Primary practice location

1502 Columbus Ave
Washington Court House, OH 43160-1767

Mailing address

147 Pinckney St
Circleville, OH 43113-1627
Phone (740) 474-8558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20141201001233 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7012239155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
30018442OHMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902818479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 PINCKNEY ST",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "431131627",
            "telephone_number": "740-474-8558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 COLUMBUS AVE",
            "city": "WASHINGTON COURT HOUSE",
            "state": "OH",
            "postal_code": "431601767",
            "telephone_number": "740-335-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVENSON",
        "first_name": "IRA",
        "middle_name": "S",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "30018442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington Court House, OH

Sources for this page

Verify at the official NPI Registry.