NPIMap

Organization Active NPI

Professional Dental Alliance, LLC

Doing business as Corner Dental Perrysburg

  • Dentist
  • Perrysburg, OH
National Provider Identifier
1952841330
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PROFESSIONAL DENTAL ALLIANCE, LLC
Doing business as
Corner Dental Perrysburg
Practice address
25680 Dixie Hwy
Perrysburg, OH 43551-2019
Phone
(567) 336-4360
NPI assigned
Mar 3, 2017
Last updated
Mar 13, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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

Authorized official

Name
Maria Jones
Title
Credentialing Specialist
Phone
(724) 698-2132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

25680 Dixie Hwy
Perrysburg, OH 43551-2019

Mailing address

11 S Mill St
Suite 200
New Castle, PA 16101-3613
Phone (724) 698-2500

Other names 1

  • Corner Dental Perrysburg Doing business as

National Provider Directory

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

Other organizations with this tax ID 20

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

View all 20

Locations

25680 Dixie Hwy
Perrysburg, OH 43551
Phone (567) 336-4360

NPI Registry JSON

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

{
    "created_epoch": "1488499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489363200000",
    "number": "1952841330",
    "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": "25680 DIXIE HWY",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435512019",
            "telephone_number": "567-336-4360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-03",
        "last_updated": "2017-03-13",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "724-698-2132"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corner Dental Perrysburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Perrysburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; 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.