Provider Demographics
NPI:1922102466
Name:PHIPPS, SHEVLIN, HEBEKA FAMILY DENTISTRY, LTD
Entity type:Organization
Organization Name:PHIPPS, SHEVLIN, HEBEKA FAMILY DENTISTRY, LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-352-2569
Mailing Address - Street 1:970 W. WOOSTER ST
Mailing Address - Street 2:SUITE 125
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402
Mailing Address - Country:US
Mailing Address - Phone:419-352-2569
Mailing Address - Fax:800-939-4801
Practice Address - Street 1:970 W WOOSTER ST
Practice Address - Street 2:SUITE 125
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-2643
Practice Address - Country:US
Practice Address - Phone:419-352-2569
Practice Address - Fax:419-352-8308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty