Pda Ortho Specialty

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

PDA ORTHO SPECIALTY

Practice address

13022 Pearl Rd Ste 23
Strongsville, OH 44136-3442

Phone

(440) 238-0770

NPI assigned

May 31, 2017

Organization subpart

No

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

Addresses

Other names 1

• Lewis Orthodontics, Inc Doing business as

Tax ID family

Lewis Orthodontics Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pda Ortho Specialty

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • New Castle, PA
  • NPI 1588950661
  NPD tax ID

Locations

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496188800000",
    "number": "1114455441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 S MILL ST STE 200",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161013680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13022 PEARL RD STE 23",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441363442",
            "telephone_number": "440-238-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PDA ORTHO SPECIALTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-31",
        "last_updated": "2017-05-31",
        "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": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lewis Orthodontics, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ciara Pavkov, BSN, RN
• James Pavkov
• Robert Alan Pavlik Jr., B.A., BC-HIS
• Ross E Pavlik, HAS
• Laura Lynn Paynter, P.C.
• Pearl Dental Practice, Inc.
• Pearle Vision Inc
• Rachel M Pearson, PA-C
• Julie Ann Penter, LPN
• Jennifer Marie Perez, FNP-BC

• Orthodontics and Dentofacial Orthopedics Dentistry in Strongsville, OH
• Providers in Strongsville, OH by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2017; 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.