MEDICARE: DR. DENNIS N ZEIDLER 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	122300000X	Dentist	DS027053L	PA
2	122300000X	Dentist	0401411185	VA

General Provider Information

NPI Number	:	1932117942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS N ZEIDLER DMD

Provider Business Mailing Address
First Line	:	1501 POTOMAC AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15216-2135
Country	:	US
Telephone Number	:	412-531-3400
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 POTOMAC AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15216-2135
Country	:	US
Telephone Number	:	412-531-3400
Fax Number	:

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

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	01/07/2017

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