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General NPI Number Information
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NPI Number | 1700849742
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Entity Type | Organization
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Legal Business Name | ALLEGHENY CLINIC
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 320 E NORTH AVE
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City | PITTSBURGH
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State | PA
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Zip | 15212-4756
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Country | US
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Telephone | 412-359-6001
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Fax | 412-359-4063
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Provider Business Mailing Address
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Address Line | 320 E NORTH AVE
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City | PITTSBURGH
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State | PA
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Zip | 15212-4756
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Country | US
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Telephone | 412-359-6001
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Fax | 412-359-4063
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Authorized Official
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Title or Position | DIRECTOR PROVIDER ENROLLMENT
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Name | DENISE NOEL
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Credential |
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Telephone | 412-770-6871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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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 | 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 #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 |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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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 | 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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