Healthcare Provider Details

I. General information

NPI: 1003116575
Provider Name (Legal Business Name): STEVE JAMES KUKUNAS DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2010
Last Update Date: 10/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 FIFTH AVENUE SUITE 301
PITTSBURGH PA
15213
US

IV. Provider business mailing address

3500 FIFTH AVENUE SUITE 301
PITTSBURGH PA
15213
US

V. Phone/Fax

Practice location:
  • Phone: 412-681-5221
  • Fax: 412-681-5221
Mailing address:
  • Phone: 412-681-5221
  • Fax: 412-681-5221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDS-025393-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: