Healthcare Provider Details

I. General information

NPI: 1245991934
Provider Name (Legal Business Name): PEDIATRIC DENTISTRY ASLEEP P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2022
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N LEWIS RUN RD STE 215A
WEST MIFFLIN PA
15122-3009
US

IV. Provider business mailing address

500 N LEWIS RUN RD STE 215A
WEST MIFFLIN PA
15122-3009
US

V. Phone/Fax

Practice location:
  • Phone: 412-672-4077
  • Fax: 412-672-4570
Mailing address:
  • Phone: 412-672-4077
  • Fax: 412-672-4570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHNNY WANA JOSEPH
Title or Position: PRESIDENT AND CEO
Credential: DMD
Phone: 412-672-4077