PROFESSIONAL DENTAL ALLIANCE SPECIALTY, LLC (NPI# 1346796869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346796869 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL DENTAL ALLIANCE SPECIALTY, LLC |
| Other Organization Name | NWO ENDODONTICS |
| Practice Address |
7131 Spring Meadows Dr W Suite C Holland OH 43528-7939 |
| Mailing Address |
11 S Mill St Ste 200 New Castle PA 16101-3613 |
| Practice Telephone | 4198657433 |
| Practice Fax Number | 4198657680 |
| Mailing Telephone | 7246982132 |
| Mailing Fax Number | 7246524619 |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2016-08-26 |
| Authorized Official Name | MARIA JONES (CRED SPECIALIST) |
| Authorized Official Telephone | 7246982132 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers |
| Other Name | Type Code |
|---|---|
| NWO Endodontics | Doing Business As Name - Organization |
| Street Address |
7131 SPRING MEADOWS DR W SUITE C |
| City | HOLLAND |
| State | OH |
| Zip Code | 43528-7939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215542345 | Bobbi Stall | Technician | 1027 Raymil, Holland, OH 43528 | 2020-09-15 |
| 1336789049 | Diana Kobylak | Licensed Practical Nurse | Racing for Recovery, 6202 Trust Dr., Holland, OH 43528 | 2020-01-10 |
| 1982262291 | Raven Diane Hannah | Licensed Vocational Nurse | 350 South Irwin Rd, Holland, OH 43528 | 2019-06-01 |
| 1881163988 | Brandon Scott Smith | Counselor | 350 S Irwin Road, Holland, OH 43528 | 2018-11-19 |
| 1184199432 | Pamela Adrienne Wilson | Rehabilitation Counselor | 350 S. Irwin Road, Holland, OH 43528 | 2018-10-12 |
| 1023509460 | Shaunte Harris | Counselor | 350 S Irwin, Holland, OH 43528 | 2018-05-22 |
| 1982193314 | William Floyd Johnson | Counselor | 350 S. Irwin, Holland, OH 43528 | 2018-05-01 |
| 1174025100 | Samantha Hoelzer | Optometrist | 1460 Spring Meadows Drive, E100, Holland, OH 43528 | 2018-03-06 |
| 1780186262 | Vicki Gottfried | Community/Behavioral Health | 7015 Spring Meadows West Drive Suite 102, Holland, OH 43528 | 2018-03-01 |
| 1922519859 | Shaunta Marie Grier | Licensed Practical Nurse | 350 S Irwin Street, Holland, OH 43528 | 2017-10-18 |
| Find all providers in zip 43528 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346660065 | Caroline Ghattas Ayoub | Dentist | 7131 Spring Meadows Dr W Ste C, Holland, OH 43528-7938 | 2014-04-21 |
| 1649373010 | William Roger Peterson | Dentist | 1730 Holloway Rd, Holland, OH 43528-8547 | 2006-09-07 |
| 1477503191 | Brian J Buurma | Dentist | 3290 North Wellness Drive, Suite 270, Holland, MI 49424 | 2006-05-11 |
| 1174524243 | Michael A Smith | Dentist | 12662 Riley St, Suite #130, Holland, MI 49424-8023 | 2005-08-10 |
| 1598172363 | Westshore Endodontics PC | Dentist | 904 Washington Ave, Suite 110, Holland, MI 49423-7724 | 2014-07-14 |
| 1588918767 | Steven M Frey | Dentist | 904 Washington Ave, Suite 110, Holland, MI 49423-7724 | 2012-11-09 |
| 1114076106 | Doulgas J. Schippers | Dentist | 577 Michigan Ave, Suite 102, Holland, MI 49423-4911 | 2007-01-09 |
| 1750331815 | James Ray Howard | Dentist | 904 S Washington Ave, Suite 110, Holland, MI 49423-7724 | 2006-05-11 |
| 1649229493 | Westshore Endodontics, P.C. | Dentist | 904 S Washington Ave, Suite 110, Holland, MI 49423-7724 | 2006-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831745868 | Iman Attar | Dentist | 2828 Euclid Ave Apt 207, Cleveland, OH 44115-2470 | 2019-08-15 |
| 1609421684 | Columbus Endodontic Specialists | Dentist | 7334 E Broad St Ste C, Blacklick, OH 43004-9239 | 2019-08-06 |
| 1336619873 | Alvaro Rodriguez | Dentist | 26200 George Zeiger Dr Apt 303, Beachwood, OH 44122-7533 | 2018-11-27 |
| 1942725551 | Meckler Dental Providers, Inc. | Dentist | 3455 Center Rd, Brunswick, OH 44212-3688 | 2017-08-04 |
| 1023532421 | Ddc Endodontics LLC | Dentist | 23250 Mercantile Rd Ste 110, Beachwood, OH 44122-5928 | 2017-07-28 |
| 1912428228 | Ghaeth H Yassen | Dentist | 2124 Cornell Drive, Cwru School of Dental Medicine, Cleveland, OH 44106 | 2017-06-28 |
| 1518401108 | Lev, Berberich, Stabile, Direnzo Ltd | Dentist | 8740 E Market St, Warren, OH 44484-2324 | 2016-12-15 |
| 1003359258 | Paul F Siegel Dds Inc | Dentist | 9403 Kenwood Rd Ste B205, Blue Ash, OH 45242-6829 | 2016-11-21 |
| 1669847463 | Magdy Beshay | Dentist | 1129 E Aurora Rd Ste 102, Macedonia, OH 44056-1988 | 2015-12-04 |
| 1215314240 | Beavercreek Endodontics- Emily Lammers Dds Ms Inc. | Dentist | 1555 Marsetta Dr, Beavercreek, OH 45432-2732 | 2015-04-28 |
| 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.