Healthcare Provider Details

I. General information

NPI: 1174580815
Provider Name (Legal Business Name): THOMAS MONROE HENDLEY III D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 09/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 PARKWAY CTR STE G1
PITTSBURGH PA
15220
US

IV. Provider business mailing address

2 PARKWAY CTR STE G1
PITTSBURGH PA
15220-3510
US

V. Phone/Fax

Practice location:
  • Phone: 412-937-1900
  • Fax:
Mailing address:
  • Phone: 412-937-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License NumberDA031803
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3504
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS041643
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: