Healthcare Provider Details

I. General information

NPI: 1619901600
Provider Name (Legal Business Name): MICHAEL A KAIL DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 08/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 COCHRAN RD
PITTSBURGH PA
15220-1203
US

IV. Provider business mailing address

1910 COCHRAN RD
PITTSBURGH PA
15220-1203
US

V. Phone/Fax

Practice location:
  • Phone: 412-343-7855
  • Fax: 412-343-7856
Mailing address:
  • Phone: 412-343-7855
  • Fax: 412-343-7856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS035466
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberDS035466
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: