Provider Demographics
NPI:1306031794
Name:LEVENE HARVELL, LEZLI (DMD)
Entity type:Individual
Prefix:DR
First Name:LEZLI
Middle Name:
Last Name:LEVENE HARVELL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 MORRIS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1063
Mailing Address - Country:US
Mailing Address - Phone:973-639-1000
Mailing Address - Fax:973-639-1006
Practice Address - Street 1:475 MORRIS AVE STE B
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1063
Practice Address - Country:US
Practice Address - Phone:973-391-1000
Practice Address - Fax:973-391-1005
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0533511223G0001X
NJ22DI023709001223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0170356Medicaid