MEDICARE: JOSEPH PENNSYLVANIA DENTAL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1851222822
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPH PENNSYLVANIA DENTAL PLLC

Provider Business Mailing Address
First Line	:	30 ISABELLA ST STE 100
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15212-5862
Country	:	US
Telephone Number	:	412-643-4813
Fax Number	:	878-223-1172

Provider Business Practice Location Address
First Line	:	30 ISABELLA ST STE 100
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15212-5862
Country	:	US
Telephone Number	:	412-643-4813
Fax Number	:	878-223-1172

Authorized Official
Title or Position	:	OWNER
Name	:	JOHNNY JOSEPH
Credential	:	DDS
Telephone Number	:	713-489-2198

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

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