Healthcare Provider Details

I. General information

NPI: 1821336314
Provider Name (Legal Business Name): DEREK KLEPSKY DMD MDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2013
Last Update Date: 01/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 EMERSON AVE
ASPINWALL PA
15215-3252
US

IV. Provider business mailing address

101 EMERSON AVE
ASPINWALL PA
15215-3252
US

V. Phone/Fax

Practice location:
  • Phone: 412-782-4944
  • Fax:
Mailing address:
  • Phone: 412-782-4944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDS031444L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: