Provider Demographics
NPI:1750461638
Name:KARNAVAS, DIANE (DMD)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:
Last Name:KARNAVAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 FOX POINTE PL
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-1537
Mailing Address - Country:US
Mailing Address - Phone:412-828-3223
Mailing Address - Fax:412-826-0756
Practice Address - Street 1:750 3RD ST
Practice Address - Street 2:SUITE 2
Practice Address - City:OAKMONT
Practice Address - State:PA
Practice Address - Zip Code:15139-1971
Practice Address - Country:US
Practice Address - Phone:412-828-3223
Practice Address - Fax:412-826-0756
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025294L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA29955-2OtherUNITED HEALTH CARE