Provider Demographics
NPI:1033230511
Name:RICHARD A. DUKOVICH, D.M.D.
Entity Type:Organization
Organization Name:RICHARD A. DUKOVICH, D.M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:DUKOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:412-831-3853
Mailing Address - Street 1:4880 LIBRARY RD STE F
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-2946
Mailing Address - Country:US
Mailing Address - Phone:412-831-3853
Mailing Address - Fax:412-831-7425
Practice Address - Street 1:4880 LIBRARY RD STE F
Practice Address - Street 2:
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-2946
Practice Address - Country:US
Practice Address - Phone:412-831-3853
Practice Address - Fax:412-831-7425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025717L122300000X
PADS036422L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA172-4132OtherCONCORDIA
PA1902976889OtherKORCH NPI
PA435-351OtherCONCORDIA
PA192-4037OtherCONCORDIA
PA1821105917OtherDUKOVICH NPI