Andrew S Matta DMD Poland LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS036253 Issued in PA

Legal business name

ANDREW S MATTA DMD POLAND LLC

Practice address

8274 Youngstown Pittsburgh Rd
Poland, OH 44514-2809

Phone

(330) 707-9808

NPI assigned

Dec 15, 2010

Last updated

Dec 15, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andrew S Matta, DMD

Title

Sole Member

Phone

(330) 533-3400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292371200000",
    "number": "1033412994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 BOARDMAN CANFIELD RD",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069029",
            "telephone_number": "330-533-3400",
            "fax_number": "330-533-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8274 YOUNGSTOWN PITTSBURGH RD",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445142809",
            "telephone_number": "330-707-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW S MATTA DMD POLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-15",
        "last_updated": "2010-12-15",
        "status": "A",
        "authorized_official_last_name": "MATTA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "330-533-3400",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS036253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Poland, OH
• Providers in Poland, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; 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.