Provider Demographics
NPI:1508991068
Name:MCCARTHY, EDWARD W (DMD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:W
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9370 MCKNIGHT RD
Mailing Address - Street 2:405 ARCADIA COURT
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5953
Mailing Address - Country:US
Mailing Address - Phone:412-367-8877
Mailing Address - Fax:412-369-9343
Practice Address - Street 1:9370 MCKNIGHT RD
Practice Address - Street 2:405 ARCADIA COURT
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5953
Practice Address - Country:US
Practice Address - Phone:412-367-8877
Practice Address - Fax:412-369-9343
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS17793-L1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT29722Medicare UPIN
PA098746Medicare ID - Type Unspecified