PROFESSIONAL DENTAL ALLAINCE OF MASSACHUSETTS PLLC (NPI# 1245878305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245878305 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL DENTAL ALLAINCE OF MASSACHUSETTS PLLC |
| Practice Address |
17 Main St Boylston MA 01505-1948 |
| Mailing Address |
11 S Mill St Ste 200 New Castle PA 16101-3680 |
| Practice Telephone | 5088696388 |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2019-12-19 |
| Authorized Official Name | ANDREW MATTA (OWNER) |
| Authorized Official Telephone | 7246982500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Innovative Dental | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 622 Main St, Shrewsbury, MA 015455639 | 5088451156 | |
| 119 S Main St, Leicester, MA 015241403 | 5088924882 |
| Street Address |
17 MAIN ST |
| City | BOYLSTON |
| State | MA |
| Zip Code | 01505-1948 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265793244 | Jonila Buzzell | Dentist | 17 Main St, Boylston, MA 01505-1948 | 2012-06-06 |
| 1235306002 | Boylston Dental Associates | Dentist | 17 Main St, Boylston, MA 01505-1948 | 2008-05-12 |
| 1922097674 | John Francis Scanlon | Dentist | 17 Main St, Boylston, MA 01505-1948 | 2005-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194879007 | Town of Boylston | Emergency Medical Technician, Basic | 599 Main St, Boylston, MA 01505-0634 | 2007-01-22 |
| 1528471323 | Lynne Lavallee | Nurse Practitioner | 56 Oak Hill Ln, Boylston, MA 01505-1200 | 2014-06-09 |
| 1699173484 | Patricia Symmes | Student in an Organized Health Care Education/Training Program | 603 Linden St, Boylston, MA 01505-1214 | 2014-12-11 |
| 1134319270 | Kreszentia M Strobel | Pediatrics | 26 Bay Path Dr, Boylston, MA 01505-1427 | 2007-07-25 |
| 1811936909 | James B Hanshaw | Pediatrics | 18 Bay Path Dr, Boylston, MA 01505-1427 | 2006-06-05 |
| 1528174232 | Karen Kiver Patalano | Dietitian, Registered | 567 Central St, Boylston, MA 01505-1523 | 2006-08-23 |
| 1114347945 | Alexander Martin | Dietitian, Registered | 567 Central St, Boylston, MA 01505-1523 | 2014-04-19 |
| 1740490036 | Carol Linda Ahlstrand Smith | Social Worker | 475 Central St, Boylston, MA 01505-1524 | 2007-05-23 |
| 1306275771 | Jeanette Mesite Frem | Lactation Consultant, Non-RN | 25 Pendell Cir, Boylston, MA 01505-1541 | 2013-11-06 |
| 1780966150 | Martine Ferullo | Pharmacist | 14 Pleasant Ln, Boylston, MA 01505-1547 | 2011-09-12 |
| Find all providers in zip 01505 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265793244 | Jonila Buzzell | Dentist | 17 Main St, Boylston, MA 01505-1948 | 2012-06-06 |
| 1235306002 | Boylston Dental Associates | Dentist | 17 Main St, Boylston, MA 01505-1948 | 2008-05-12 |
| 1922097674 | John Francis Scanlon | Dentist | 17 Main St, Boylston, MA 01505-1948 | 2005-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083213821 | Rebekah Collins | Dentist | 95 University Ave Unit 2232, Westwood, MA 02090-2379 | 2020-10-22 |
| 1902405202 | Robert Marc Grassi | Dentist | 18 Sussex Rd, Winchester, MA 01890-3849 | 2020-10-19 |
| 1558968784 | Francina Alvarez Noboa | Dentist | 700 Huron Ave Apt 15m, Cambridge, MA 02138-4590 | 2020-10-01 |
| 1447867692 | Anisha Sharma | Dentist | 50 Malden St Apt 611, Boston, MA 02118-2894 | 2020-09-30 |
| 1548877897 | Alexandra Gilbert | Dentist | 15 Williams St, Beverly, MA 01915-2323 | 2020-09-29 |
| 1639785777 | Spring Hill Dental | Dentist | 174 Highland Ave Ste 1, Somerville, MA 02143-1546 | 2020-09-22 |
| 1174139703 | Ervin Pejo | Dentist | 824 William S Canning Blvd A, Fall River, MA 02721 | 2020-09-18 |
| 1497360572 | Nivedhitha Ramesh | Dentist | 715 Albany St # 437, Boston, MA 02118-2526 | 2020-09-15 |
| 1346854718 | Barbara A Lawnicki Dmd PC | Dentist | 1068 Massachusetts Ave, Arlington, MA 02476-4311 | 2020-09-03 |
| 1720699556 | Kanza Tauqir | Dentist | 41 North Rd Ste 207, Bedford, MA 01730-1037 | 2020-08-14 |
| Find all providers with the same taxonomy | ||||
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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.