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General NPI Number Information
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NPI Number | 1588125454
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Entity Type | Individual
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Provider Name | KATHERINE NICOLE RICHARDSON MS, DDS
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Gender | Female
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 06/11/2020
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Provider Practice Location Address
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Address Line | 3501 TERRACE STREET G-32 SALK HALL
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City | PITTSBURGH
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State | PA
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Zip | 15261-7001
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Country | US
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Telephone | 412-648-8604
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Fax |
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Provider Business Mailing Address
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Address Line | 3600 FORBES AVE STE 140
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City | PITTSBURGH
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State | PA
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Zip | 15213-3410
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Country | US
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Telephone | 512-659-0814
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 10324
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License Number State | KY
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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 | 35484
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS042716
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License Number State | PA
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