Provider Demographics
NPI:1215094628
Name:LEVON, JOHN ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ALAN
Last Name:LEVON
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:7240 CREEKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:IN
Mailing Address - Zip Code:46167-9108
Mailing Address - Country:US
Mailing Address - Phone:317-274-5628
Mailing Address - Fax:317-274-6583
Practice Address - Street 1:1121 W MICHIGAN ST
Practice Address - Street 2:IU SCHOOL OF DENTISTRY, ROOM 286B
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5211
Practice Address - Country:US
Practice Address - Phone:317-274-5628
Practice Address - Fax:317-274-6583
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120076291223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics