Provider Demographics
NPI:1750364162
Name:PRASAD, JOANNE LEGER (DDS)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:LEGER
Last Name:PRASAD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:MICHELLE
Other - Last Name:LEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3501 TERRACE STREET
Mailing Address - Street 2:SUITE G-133
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15261-0001
Mailing Address - Country:US
Mailing Address - Phone:412-648-8637
Mailing Address - Fax:412-383-9142
Practice Address - Street 1:3501 TERRACE STREET
Practice Address - Street 2:SUITE G-133
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15261-0001
Practice Address - Country:US
Practice Address - Phone:412-648-8637
Practice Address - Fax:412-383-9142
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0364471223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology