Professional Dental Alliance, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

30.022469 Issued in OH

Legal business name

PROFESSIONAL DENTAL ALLIANCE, LLC

Practice address

6325 N Ridge Rd
Madison, OH 44057-2547

Phone

(440) 428-1145

NPI assigned

Oct 3, 2016

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, DMD

Title

Owner

Phone

(724) 698-2500

Specialties & licenses 1

Addresses

Other names 1

• Dental Care of Ohio, Madison Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas Leroy Appelfeller, D.D.S.

  • General Practice Dentistry
  • Madison, OH
  • NPI 1649331182
  NPD (past)

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475452800000",
    "number": "1164971024",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6325 N RIDGE RD",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440572547",
            "telephone_number": "440-428-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "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.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.022469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care of Ohio, Madison",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phoenix Residential Centers, Inc.
• Carleen Pierce, R.PH.
• Shae L Platt
• Gerri Ann Podpadec
• Proactive Cardiology LLC
• John E Prokop, LMT
• Justine Marie Pupparo, RN,BSN
• Py Medical Services of Oh Inc
• Brenda Rarick, CRNA
• Kathryn E Rasch, RPH

• Dentist in Madison, OH
• Providers in Madison, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; 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.