MEDICARE: DR. DANIEL KIRKPATRICK DDS

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DS041623	PA
2	390200000X	Student in an Organized Health Care Education/Training Program		MO
3	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	DS041623	PA

General Provider Information

NPI Number	:	1205360427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL KIRKPATRICK DDS

Provider Business Mailing Address
First Line	:	1416 MOUNT ROYAL BLVD
Second Line	:
City	:	GLENSHAW
State	:	PA
Zip	:	15116-2206
Country	:	US
Telephone Number	:	412-223-5880
Fax Number	:

Provider Business Practice Location Address
First Line	:	1416 MOUNT ROYAL BLVD
Second Line	:
City	:	GLENSHAW
State	:	PA
Zip	:	15116-2206
Country	:	US
Telephone Number	:	412-223-5880
Fax Number	:	412-223-5883

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

Provider Enumeration Date	:	04/13/2017
Last Update Date	:	07/02/2023

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