Healthcare Provider Details

I. General information

NPI: 1750736922
Provider Name (Legal Business Name): DANIEL ROBERT HAWKINS D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2016
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 TERRACE STREET SUITE 3189
PITTSBURGH PA
15261-5051
US

IV. Provider business mailing address

521 N 11TH ST FL 3
RICHMOND VA
23298-5016
US

V. Phone/Fax

Practice location:
  • Phone: 412-648-9100
  • Fax: 412-383-7862
Mailing address:
  • Phone: 804-828-3584
  • Fax: 804-828-0056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number0401416865
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number0442000282
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS041021
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number0442000282
License Number StateVA
# 6
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberDS041021
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: