Healthcare Provider Details

I. General information

NPI: 1205665171
Provider Name (Legal Business Name): OMER LIAQAT GHANI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2024
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4730 CLAIRTON BLVD
PITTSBURGH PA
15236-2159
US

IV. Provider business mailing address

3108 RIVERFRONT DR
PITTSBURGH PA
15238-3184
US

V. Phone/Fax

Practice location:
  • Phone: 412-882-2075
  • Fax:
Mailing address:
  • Phone: 406-969-9707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS044671
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: