Professional Dental Alliance of Meridian, PLLC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

PROFESSIONAL DENTAL ALLIANCE OF MERIDIAN, PLLC

Practice address

1415 River Ave Ste B
Cumberland, MD 21502-4629

Phone

(240) 362-7017

NPI assigned

Oct 31, 2022

Last updated

Dec 14, 2023By 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

Erica Quinteros

Title

Credentialing

Phone

(724) 698-2135

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702512000000",
    "number": "1700593779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 S MILL ST",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161013680",
            "telephone_number": "724-698-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 RIVER AVE STE B",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215024629",
            "telephone_number": "240-362-7017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 Omega Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217405784",
            "country_code": "US",
            "telephone_number": "301-733-6077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16069 Comprint Cir",
            "address_purpose": "LOCATION",
            "city": "Gaithersburg",
            "state": "MD",
            "postal_code": "208771321",
            "country_code": "US",
            "telephone_number": "301-663-0301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "85 Thomas Johnson Ct Ste A",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024331",
            "country_code": "US",
            "telephone_number": "301-663-0052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE OF MERIDIAN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-31",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A",
        "authorized_official_last_name": "QUINTEROS",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "724-698-2135"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endodontics in Cumberland, MD
• Providers in Cumberland, MD by specialty
• Endodontics in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; 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.