MEDICARE: DR. ERIC RYAN SMIGA D.M.D.

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	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	DS030569L	PA
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DS030569L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861478455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC RYAN SMIGA D.M.D.

Provider Business Mailing Address
First Line	:	5820 CENTRE AVE STE 200
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15206-3710
Country	:	US
Telephone Number	:	412-661-7693
Fax Number	:

Provider Business Practice Location Address
First Line	:	180 FORT COUCH RD STE 450
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15241-1031
Country	:	US
Telephone Number	:	412-595-7775
Fax Number	:

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

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	11/07/2024

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