Healthcare Provider Details

I. General information

NPI: 1306809876
Provider Name (Legal Business Name): KARL WEISS DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 02/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1597 WASHINGTON PIKE SUITE A5
BRIDGEVILLE PA
15017-2881
US

IV. Provider business mailing address

926 GREAT POND DR SUITE 2003
ALTAMONTE SPRINGS FL
32714-7244
US

V. Phone/Fax

Practice location:
  • Phone: 412-279-4800
  • Fax: 412-279-7119
Mailing address:
  • Phone: 407-772-5124
  • Fax: 407-788-3572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberS3-217C
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberD7644
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number13913
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDS028733L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: