Provider Demographics
NPI:1053524462
Name:LEVINSKY, MARK (DDS)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:LEVINSKY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5001 QUEEN PALM TER NE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-6305
Mailing Address - Country:US
Mailing Address - Phone:727-527-7733
Mailing Address - Fax:727-527-7733
Practice Address - Street 1:5200 16TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-2612
Practice Address - Country:US
Practice Address - Phone:727-527-7733
Practice Address - Fax:727-527-7733
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLDN00123441223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery