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PROFESSIONAL DENTAL ALLIANCE
NPI 1083919252
Dentist - General Practice in Boardman, OH

Active since January 20, 2011
99 DEBARTOLO PL, BOARDMAN, OH 44512(330) 758-2348(330) 533-2700 Get Directions Write a Review

NPPES record last updated: January 20, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Professional Dental Alliance NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROFESSIONAL DENTAL ALLIANCE (NPI 1083919252) is a healthcare organization registered as a general practice in Boardman, Ohio and active in the NPI registry since January 2011. The organization lists Andrew S Matta, Member, as its authorized official.

NPPES Registry Identity

NPI1083919252
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePROFESSIONAL DENTAL ALLIANCE
Location Address99 DEBARTOLO PLBoardman, OH 44512-7014
Mailing Address3800 Boardman Canfield RdCanfield, OH 44406-9029 · (330) 533-3400 · Fax (330) 533-2700
Phone(330) 758-2348
Fax(330) 533-2700
Organization SubpartYes
Authorized OfficialAndrew S MattaMember · (330) 533-3400
Enumeration DateJanuary 20, 2011
✔ NPI 1083919252 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in OH · 30022469
Definition
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.
99 DEBARTOLO PL, Boardman, OH 44512
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID A WYATT, DDS, LLS
Dentist
99 DEBARTOLO PL
BOARDMAN, OH 44512
Mahoning County (330) 758-2348
DR. CHAD W WISE D.D.S.
Dentist
99 DEBARTOLO PL
BOARDMAN, OH 44512
Mahoning County (330) 758-2348
DR. DAVID A WYATT DDS
Dentist
99 DEBARTOLO PL
BOARDMAN, OH 44512
Mahoning County (330) 758-2348

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Professional Dental Alliance's NPI number?

The NPI number for Professional Dental Alliance is 1083919252. It was assigned to this organization in the NPPES registry on January 20, 2011.

Where is Professional Dental Alliance located?

Professional Dental Alliance is located at 99 Debartolo Pl, Boardman, OH 44512. The listed phone number is (330) 758-2348.

What is Professional Dental Alliance's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Professional Dental Alliance was last updated on January 20, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.