Provider Demographics
NPI:1598427767
Name:SHELLY LEVIN-RUBIN PLLC
Entity type:Organization
Organization Name:SHELLY LEVIN-RUBIN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVIN-RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-808-4277
Mailing Address - Street 1:21301 POWERLINE RD STE 208
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-2390
Mailing Address - Country:US
Mailing Address - Phone:516-808-4277
Mailing Address - Fax:866-873-8279
Practice Address - Street 1:21301 POWERLINE RD STE 208
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-2390
Practice Address - Country:US
Practice Address - Phone:614-482-8000
Practice Address - Fax:866-873-8279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-06
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty