Provider Demographics
NPI:1548956865
Name:DICOSTANZO DMD PLLC
Entity type:Organization
Organization Name:DICOSTANZO DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:DICOSTANZO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:412-264-6229
Mailing Address - Street 1:106 HIDDEN VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-9381
Mailing Address - Country:US
Mailing Address - Phone:484-574-4564
Mailing Address - Fax:
Practice Address - Street 1:1009 BEAVER GRADE RD STE 300
Practice Address - Street 2:
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-2969
Practice Address - Country:US
Practice Address - Phone:412-264-6229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty