Healthcare Provider Details

I. General information

NPI: 1609576107
Provider Name (Legal Business Name): KUKUNAS PROSTHODONTICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2023
Last Update Date: 03/06/2023
Certification Date: 03/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3516 5TH AVE STE 101
PITTSBURGH PA
15213-3332
US

IV. Provider business mailing address

3516 5TH AVE STE 101
PITTSBURGH PA
15213-3332
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 Number
License Number State

VIII. Authorized Official

Name: DR. PAUL S KUKUNAS
Title or Position: PROSTHODONTIST
Credential: DMD
Phone: 412-877-6157