Provider Demographics
NPI:1528023322
Name:UNIVERSITY OF PITTSBURGH SCHOOL OF DENTAL MEDICINE
Entity Type:Organization
Organization Name:UNIVERSITY OF PITTSBURGH SCHOOL OF DENTAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM DEAN
Authorized Official - Prefix:
Authorized Official - First Name:MARNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OAKLEY
Authorized Official - Suffix:III
Authorized Official - Credentials:DMD
Authorized Official - Phone:412-648-3100
Mailing Address - Street 1:3501 TERRACE ST
Mailing Address - Street 2:SALK HALL
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2523
Mailing Address - Country:US
Mailing Address - Phone:412-648-3100
Mailing Address - Fax:412-383-7169
Practice Address - Street 1:3501 TERRACE ST
Practice Address - Street 2:SALK HALL
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2523
Practice Address - Country:US
Practice Address - Phone:412-648-3100
Practice Address - Fax:412-383-7169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA67906OtherUNISON
PA1001381400014Medicaid
PA2439OtherUPMC FOR YOU
PA154327OtherUNITED CONCORDIA PROVIDER
PA6701-1OtherGATEWAY