Healthcare Provider Details

I. General information

NPI: 1366864084
Provider Name (Legal Business Name): JOHN HART DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2014
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 CENTRE AVE
PITTSBURGH PA
15213-1763
US

IV. Provider business mailing address

4700 CENTRE AVE
PITTSBURGH PA
15213-1763
US

V. Phone/Fax

Practice location:
  • Phone: 412-681-8011
  • Fax: 412-681-9614
Mailing address:
  • Phone: 412-681-8011
  • Fax: 412-681-9614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberDS026960L
License Number StatePA

VIII. Authorized Official

Name: DR. JOHN W HART
Title or Position: PRESIDENT
Credential: DDS
Phone: 412-681-8011