Individual provider Active NPI

Edward L Korenman, D.M.D.

  • General Practice Dentistry
  • Pittsburgh, PA
National Provider Identifier
1669587101
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS020862L Issued in PA
Practice address
4351 Murray Ave
Pittsburgh, PA 15217-2905
Phone
(412) 422-5150
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
Yes

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
General Practice Dentistry 1223G0001X DS020862L PA Primary

Addresses

Primary practice location

4351 Murray Ave
Pittsburgh, PA 15217-2905

Mailing address

4351 Murray Ave
Pittsburgh, PA 15217-2905
Phone (412) 422-5150

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
I20150209001848 PA Order and Referring Only - DentistPractitioner - Dentist 9537484860

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS020862LPAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669587101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4351 MURRAY AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152172905",
            "telephone_number": "412-422-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4351 MURRAY AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152172905",
            "telephone_number": "412-422-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORENMAN",
        "first_name": "EDWARD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS020862L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.