Professional Dental Alliance of Martins Ferry, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PROFESSIONAL DENTAL ALLIANCE OF MARTINS FERRY, LLC

Practice address

340 28TH St Ste 340
Bellaire, OH 43906-1789

Phone

(866) 471-4028

NPI assigned

Mar 28, 2019

Last updated

Dec 9, 2024By 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

Amanda Kurtz

Title

Credentialing Specialist

Phone

(724) 698-2946

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1548721905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 ENTERPRISE DR STE 200",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152751223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 28TH ST STE 340",
            "city": "BELLAIRE",
            "state": "OH",
            "postal_code": "439061789",
            "telephone_number": "866-471-4028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE OF MARTINS FERRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-28",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "KURTZ",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "724-698-2946"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.