1598809956 NPI number — DR. JOSEPH M CAVALIER DMD, MDS

Table of content: DR. JOSEPH M CAVALIER DMD, MDS (NPI 1598809956)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598809956 NPI number — DR. JOSEPH M CAVALIER DMD, MDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAVALIER
Provider First Name:
JOSEPH
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD, MDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598809956
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
812 ROWENA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EBENSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15931-2070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-472-4304
Provider Business Mailing Address Fax Number:
814-472-4354

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3135 NEW GERMANY RD
Provider Second Line Business Practice Location Address:
#33
Provider Business Practice Location Address City Name:
EBENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15931-4347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-472-4304
Provider Business Practice Location Address Fax Number:
814-472-4354
Provider Enumeration Date:
02/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223X0400X , with the licence number:  DS029516L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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