Healthcare Provider Details

I. General information

NPI: 1568263622
Provider Name (Legal Business Name): MICHAEL VINCENT PICCIRILLI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6808 GREENWOOD ST
PITTSBURGH PA
15206-1085
US

IV. Provider business mailing address

1050 PEARL ST
SHARON PA
16146-3620
US

V. Phone/Fax

Practice location:
  • Phone: 412-362-5677
  • Fax:
Mailing address:
  • Phone: 724-815-6798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS045680
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: