Provider Demographics
NPI:1861777559
Name:LEVY, YANE (DDS)
Entity type:Individual
Prefix:
First Name:YANE
Middle Name:
Last Name:LEVY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:YANE
Other - Middle Name:
Other - Last Name:LEVY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:2217 S ANCHOR ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-4906
Mailing Address - Country:US
Mailing Address - Phone:562-397-4437
Mailing Address - Fax:
Practice Address - Street 1:2217 S ANCHOR ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92802-4906
Practice Address - Country:US
Practice Address - Phone:562-397-4437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42354122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist