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General NPI Number Information
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NPI Number | 1194788653
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Entity Type | Organization
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Legal Business Name | UNIVERSITY DENTAL HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 04/07/2006
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Last Update Date | 01/30/2024
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Provider Practice Location Address
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Address Line | 3501 TERRACE STREET SUITE 3189
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City | PITTSBURGH
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State | PA
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Zip | 15261
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Country | US
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Telephone | 412-648-9100
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Fax | 412-383-7862
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Provider Business Mailing Address
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Address Line | 3501 TERRACE STREET SUITE 3189
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City | PITTSBURGH
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State | PA
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Zip | 15261
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Country | US
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Telephone | 412-648-9100
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Fax | 412-383-7862
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Authorized Official
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Title or Position | DEAN OF THE UNIVERSITY OF PITTSBURG
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Name | BERNARD J COSTELLO
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Credential | DMD, MD
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Telephone | 412-648-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 125Q00000X
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Taxonomy Name | Oral Medicine Dentistry
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | PA
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Taxonomy #7
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | PA
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