Provider Demographics
NPI:1194944348
Name:LEVINE, LOIS BETH (DDS)
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:BETH
Last Name:LEVINE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3366 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-3718
Mailing Address - Country:US
Mailing Address - Phone:516-826-4949
Mailing Address - Fax:516-826-2707
Practice Address - Street 1:3366 PARK AVE
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-3718
Practice Address - Country:US
Practice Address - Phone:516-826-4949
Practice Address - Fax:516-826-2707
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0393181223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics