Provider Demographics
NPI:1255351888
Name:LEVY, DEXTER S (M D P C)
Entity type:Individual
Prefix:DR
First Name:DEXTER
Middle Name:S
Last Name:LEVY
Suffix:
Gender:M
Credentials:M D P C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8966 W BOWLES AVE
Mailing Address - Street 2:#L
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-8613
Mailing Address - Country:US
Mailing Address - Phone:303-972-2727
Mailing Address - Fax:303-972-8652
Practice Address - Street 1:8966 W BOWLES AVE
Practice Address - Street 2:#L
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-8613
Practice Address - Country:US
Practice Address - Phone:303-972-2727
Practice Address - Fax:303-972-8652
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19855207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COE22405Medicare UPIN
COC88304Medicare PIN
COC88314Medicare PIN