PROFESSIONAL DENTAL ALLIANCE (NPI# 1023312451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023312451 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL DENTAL ALLIANCE |
| Practice Address |
3800 Boardman Canfield Rd Canfield OH 44406-9029 |
| Practice Telephone | 3305333400 |
| Practice Fax Number | 3305332700 |
| Mailing Telephone | 3305333400 |
| Mailing Fax Number | 3305332700 |
| Enumeration Date | 2010-12-28 |
| Last Update Date | 2010-12-28 |
| Authorized Official Name | DR. ANDREW S MATTA (MEMBER) |
| Authorized Official Telephone | 3305333400 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DS036253 | PA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790179992 | Professional Dental Alliance | Dentist | 11201 Shaker Blvd, 136, Cleveland, OH 44104-3869 | 2015-03-25 |
| 1407151673 | Professional Dental Alliance | Dentist | 7043 Pearl Rd, Middleburg Heights, OH 44130-4973 | 2011-01-20 |
| 1952606121 | Professional Dental Alliance | Dentist | 750 E Washington St, Suite A3, Medina, OH 44256-2196 | 2011-01-20 |
| 1457656621 | Professional Dental Alliance | Dentist | 6540 South Ave, Boardman, OH 44512-3651 | 2011-01-20 |
| 1962707133 | Professional Dental Alliance | Dentist | 6285 Youngstown Warren Rd, Niles, OH 44446-4656 | 2011-01-20 |
| 1508161779 | Professional Dental Alliance | Dentist | 12808 Drexmore Rd, Shaker Heights, OH 44120-5609 | 2011-01-20 |
| 1447555610 | Professional Dental Alliance | Dentist | 1951 State Route 59, Suite B, Kent, OH 44240-8128 | 2011-01-20 |
| 1083919252 | Professional Dental Alliance | Dentist | 99 Debartolo Pl, Boardman, OH 44512-7014 | 2011-01-20 |
| 1891090064 | Professional Dental Alliance | Dentist | 3729 Lee Rd, Shaker Heights, OH 44120-5103 | 2011-01-20 |
| 1770888943 | Professional Dental Alliance | Dentist | 721 S Union Ave, Alliance, OH 44601-2932 | 2011-01-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | PROFESSIONAL DENTAL ALLIANCE OF BETHEL, PLLC | 11 South Mill Street, Suite 200, New Castle, PA 16101 |
| Connecticut Business Registrations | Professional Dental Alliance of Colchester, Pllc | 11 South Mill Street, Suite 200, New Castle, PA 16101 |
| Connecticut Business Registrations | PROFESSIONAL DENTAL ALLIANCE OF CONNECTICUT, PLLC | 11 South Mill St Ste 200, New Castle, PA 16101 |
| Connecticut Business Registrations | Professional Dental Alliance of Ct 07009 - 07014 Ortho, Pllc | 11 S. Mill St., Ste. 200, New Castle, PA 16101 |
| Connecticut Business Registrations | PROFESSIONAL DENTAL ALLIANCE OF CT 07009 - 07014 PEDS, PLLC | 11 S. Mill St., Ste. 200, New Castle, PA 16101 |
| Indiana Business Entities | PROFESSIONAL DENTAL ALLIANCE OF INDIANA, LLC | 11 S Mill St, Ste 200, New Castle, PA 16101 |
| Connecticut Business Registrations | PROFESSIONAL DENTAL ALLIANCE OF MILFORD, PLLC | 11 South Mill Street, Suite 200, New Castle, PA 16101 |
| New York State Corporations | PROFESSIONAL DENTAL ALLIANCE OF NEW YORK, PLLC | 80 State Street, Albany, Ny 122072543 |
| Connecticut Business Registrations | PROFESSIONAL DENTAL ALLIANCE OF NORTHFORD, PLLC | 11 South Mill Street, Suite 20, New Castle, PA 16101 |
| Connecticut Business Registrations | PROFESSIONAL DENTAL ALLIANCE OF NORWALK, PLLC | 11 South Mill Street, Suite 200, New Castle, PA 16101 |
| Street Address |
3800 BOARDMAN CANFIELD RD |
| City | CANFIELD |
| State | OH |
| Zip Code | 44406-9029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417250754 | Dr. James Lucido,dds LLC | Dentist | 3800 Boardman Canfield Rd, Canfield, OH 44406-9029 | 2010-12-08 |
| 1811261712 | Professional Dental Alliance LLC | Dentist | 3800 Boardman Canfield Rd, Canfield, OH 44406-9029 | 2012-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952802282 | Julie Nicole Austalosh | Case Manager/Care Coordinator | 3711 Indian Run Dr Apt 7, Canfield, OH 44406 | 2018-02-22 |
| 1073064887 | Abby Smith | Specialist/Technologist | 250 Lake Pointe Circle, Canfield, OH 44406 | 2016-10-17 |
| 1255887949 | Chris Smallwood II | Driver | 6128 St Andrews Dr, Canfield, OH 44406 | 2016-09-01 |
| 1831572064 | Gateways To Better Living | Intermediate Care Facility, Mentally Retarded | 41 Talsman Drive, Youngstown, OH 44406 | 2015-07-07 |
| 1568845790 | Gateways To Better Living | Intermediate Care Facility, Mentally Retarded | 3222 Forty Second Street, Youngstown, OH 44406 | 2015-07-07 |
| 1003212051 | Diane Pool | Registered Nurse | 100 Wadsworth Street, Canfield, OH 44406 | 2014-11-18 |
| 1215353990 | Jeanne Siverd | Occupational Therapy Assistant | 11300 Columbiana-canfield Rd., Suite E, Canfield, OH 44406 | 2014-03-05 |
| 1134565641 | Dema Halasa Esper | Dietitian, Registered | 52 Timber Run Dr., Canfield, OH 44406 | 2013-05-13 |
| 1851680615 | Kimberly Jean Fyock | Licensed Practical Nurse | 7720 Lydia Ln, Canfield, OH 44406 | 2011-04-01 |
| 1205060654 | Jennifer L Morris | Registered Nurse | 3787 Mercedes Place, Canfield, OH 44406 | 2009-05-13 |
| Find all providers in zip 44406 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730388208 | Brian Thomas Weibling | Dentist | 3870 Starrs Centre Dr, Canfield, OH 44406-8003 | 2007-07-15 |
| 1265505663 | Lori A Fitzgerald | Dentist | 5711 Shields Rd, Suite A, Canfield, OH 44406 | 2006-11-16 |
| 1891801239 | Gary Todd Hubbard | Dentist | 33 Talsman Dr, Canfield, OH 44406-1207 | 2006-08-21 |
| 1326077843 | James Edward Ellashek | Dentist | 3665 Stutz Dr, Suite 2, Canfield, OH 44406-9144 | 2006-06-30 |
| 1720072168 | Pamela A Barkett | Dentist | 13 Lisbon St, Canfield, OH 44406-1415 | 2005-08-31 |
| 1750774287 | Ellashek Dental LLC | Dentist | 3665 Stutz Dr, Canfield, OH 44406-9144 | 2015-03-09 |
| 1568799070 | Christopher Allaman | Dentist | 3830 Starrs Centre Dr, Canfield, OH 44406-8003 | 2009-11-05 |
| 1013166727 | Jennifer L Gerbasi | Dentist | 33 Talsman Dr, Canfield, OH 44406-1207 | 2008-09-17 |
| 1972638385 | Raymond W Najem | Dentist | 6470 Tippecanoe Rd, Canfield, OH 44406 | 2007-02-23 |
| 1043382088 | Charles John Yourstowsky | Dentist | 3665 Stutz Dr, Suite 1, Canfield, OH 44406-9144 | 2006-11-14 |
| Find all providers in CANFIELD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.