Provider Demographics
NPI:1255704417
Name:CHILDREN'S HOSPITAL OF PITTSBURGH
Entity type:Organization
Organization Name:CHILDREN'S HOSPITAL OF PITTSBURGH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTAL RESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAYLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-452-7752
Mailing Address - Street 1:4607 CORDAY WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1918
Mailing Address - Country:US
Mailing Address - Phone:805-452-7752
Mailing Address - Fax:
Practice Address - Street 1:4401 PENN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1334
Practice Address - Country:US
Practice Address - Phone:412-692-7543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64479282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA64479OtherCALIFORNIA DENTAL LICENSE NUMBER