Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Levi Michael Upham, DDS

Individual provider Dentist · NPI 1174416564

Levi Michael Upham, DDS is a Dentist in Wilkes Barre, Pennsylvania. Qualified in 2024, 2 years ago. Licensed in Pennsylvania.

Years since qualifying
2
Licensed in
PA
In the registry since
2025
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

See every abbreviation used in this directory →

Practice location Address checks out

1111 E End Blvd
Wilkes Barre, PA 18711-0030
Phone: (570) 824-3521
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence DS044755 (PA)

Record details

NPI number1174416564
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedJune 2, 2025
Last updated in NPPESJune 2, 2025
Certification dateMay 30, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDENTIST
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Wilkes Barre