MEDICARE: DR. OLIVIA ANN KUBLI DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DS045034	PA

General Provider Information

NPI Number	:	1053299701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OLIVIA ANN KUBLI DMD

Provider Business Mailing Address
First Line	:	420 CENTER AVE
Second Line	:
City	:	GREENSBURG
State	:	PA
Zip	:	15601-1927
Country	:	US
Telephone Number	:	412-956-4590
Fax Number	:

Provider Business Practice Location Address
First Line	:	4741 CLAIRTON BLVD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15236-2115
Country	:	US
Telephone Number	:	888-766-6130
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2025
Last Update Date	:	08/21/2025

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