Professional Dental Alliance of Warren, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PROFESSIONAL DENTAL ALLIANCE OF WARREN, LLC

Practice address

4329 Mahoning Ave NW Ste B
Warren, OH 44483-1974

Phone

(330) 847-7373

NPI assigned

Apr 8, 2019

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

Practitioners 1

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

• George Edward Ralph, D.D.S.5

  • General Practice Dentistry
  • Warren, OH
  • NPI 1174516728
  NPD (past)

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1922561919",
    "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": "4329 MAHONING AVE NW STE B",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444831974",
            "telephone_number": "330-847-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE OF WARREN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-08",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonja Priest
• Daniel Alan Prince
• Loretta Prince, MSW/LSW
• Ruth Ellen Prince
• Sylvia Prince
• Michael Prokop
• Kevin Prosnick, PH.D.
• Susan L Province Romea, RN MHS ADVANCED PRAC
• Psycare, Inc.
• Psycare, Inc.

• All providers in Warren, OH
• Dentist in Ohio

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