NPIMap

Organization Active NPI

Professional Dental Alliance of Indiana, LLC

  • Dentist
  • New Castle, PA
National Provider Identifier
1013372903
Registry record updated Dec 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12012359A Issued in IN
Legal business name
PROFESSIONAL DENTAL ALLIANCE OF INDIANA, LLC
Practice address
11 S Mill St
Suite 200
New Castle, PA 16101-3613
Phone
(724) 698-2500
Fax
(724) 652-4160
NPI assigned
Dec 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Andrew Matta
Title
Owner
Phone
(724) 698-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 12012359A IN Primary

Addresses

Primary practice location

11 S Mill St
Suite 200
New Castle, PA 16101-3613

Mailing address

11 S Mill St
Suite 200
New Castle, PA 16101-3613
Phone (724) 698-2500

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451174400000",
    "number": "1013372903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 S MILL ST",
            "address_2": "SUITE 200",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161013613",
            "telephone_number": "724-698-2500",
            "fax_number": "724-652-4160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 S MILL ST",
            "address_2": "SUITE 200",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161013613",
            "telephone_number": "724-698-2500",
            "fax_number": "724-652-4160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE OF INDIANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-21",
        "last_updated": "2015-12-27",
        "status": "A",
        "authorized_official_last_name": "MATTA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-698-2500",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012359A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Castle, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.