Individual provider Active NPI

Richard L Gottlieb, DMD

  • Dentist
  • Pittsburgh, PA
National Provider Identifier
1457360232
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS019619L Issued in PA
Practice address
3347 Forbes Ave
Suite 302
Pittsburgh, PA 15213
Phone
(412) 682-7017
Fax
(412) 782-4157
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS019619L PA Primary

Addresses

Primary practice location

3347 Forbes Ave
Suite 302
Pittsburgh, PA 15213

Mailing address

3347 Forbes Ave
Suite 302
Pittsburgh, PA 15213
Phone (412) 682-7017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150709001101 PA Order and Referring Only - DentistPractitioner - Dentist 8426360124

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457360232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3347 FORBES AVE",
            "address_2": "SUITE 302",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15213",
            "telephone_number": "412-682-7017",
            "fax_number": "412-782-4157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3347 FORBES AVE",
            "address_2": "SUITE 302",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15213",
            "telephone_number": "412-682-7017",
            "fax_number": "412-782-4157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "RICHARD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS019619L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.