NPIMap

Organization Active NPI

Professional Dental Alliance

  • General Practice Dentistry
  • New Castle, PA
National Provider Identifier
1144525858
Registry record updated Jan 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DP000590 Issued in PA
Legal business name
PROFESSIONAL DENTAL ALLIANCE
Practice address
2623 Wilmington Rd
Suite a
New Castle, PA 16105-1529
Phone
(724) 658-0822
Fax
(330) 533-2700
NPI assigned
Jan 12, 2011
Last updated
Jan 12, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
PROFESSIONAL DENTAL ALLIANCEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 12, 2011

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

Authorized official

Name
Andrew S Matta, DMDNPI 1598800369
Title
Member
Phone
(330) 533-3400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DP000590 PA Primary

Addresses

Primary practice location

2623 Wilmington Rd
Suite a
New Castle, PA 16105-1529

Mailing address

3800 Boardman Canfield Rd
Canfield, OH 44406-9029
Phone (330) 533-3400

National Provider Directory

National Provider Directory
Tax ID family
Professional Dental Alliance LLC21 organizations share this tax ID, including this one
Part of
Professional Dental Alliance LLC

Other organizations with this tax ID 20

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

View all 20

Locations

2623 Wilmington Rd
#A
New Castle, PA 16105
Phone (724) 657-0884

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294790400000",
    "number": "1144525858",
    "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": "2623 WILMINGTON RD",
            "address_2": "SUITE A",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161051529",
            "telephone_number": "724-658-0822",
            "fax_number": "330-533-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROFESSIONAL DENTAL ALLIANCE",
        "enumeration_date": "2011-01-12",
        "last_updated": "2011-01-12",
        "status": "A",
        "authorized_official_last_name": "MATTA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "330-533-3400",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DP000590",
            "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 Jan 12, 2011; 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.