Healthcare Provider Details

I. General information

NPI: 1720913429
Provider Name (Legal Business Name): GAVIN ABRAM BARCLAY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 BROUGHTON RD # 200
PITTSBURGH PA
15236-3451
US

IV. Provider business mailing address

5903 5TH AVE APT 308B
PITTSBURGH PA
15232-2848
US

V. Phone/Fax

Practice location:
  • Phone: 412-886-9999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS045724
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: