Healthcare Provider Details

I. General information

NPI: 1427061985
Provider Name (Legal Business Name): JAMES ALEXANDER DIPERNA JR. D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 05/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

563 EPSILON DR SUITE 300
PITTSBURGH PA
15238-2816
US

IV. Provider business mailing address

563 EPSILON DR SUITE 300
PITTSBURGH PA
15238-2816
US

V. Phone/Fax

Practice location:
  • Phone: 412-963-1911
  • Fax: 412-967-1972
Mailing address:
  • Phone: 412-963-1911
  • Fax: 412-967-1972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDS-025943-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: