PROFESSIONAL DENTAL ALLIANCE OF CENTERVILLE, LLC
NPI 1124672092
Dentist - Oral and Maxillofacial Surgery in Centerville, OH

Active since July 30, 2019
9420 DAYTON LEBANON PIKE, CENTERVILLE, OH 45458(937) 433-8900 Get Directions Write a Review

NPPES record last updated: July 30, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Professional Dental Alliance Of Centerville, Llc NPPES

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

PROFESSIONAL DENTAL ALLIANCE OF CENTERVILLE, LLC (NPI 1124672092) is a healthcare organization registered as an oral and maxillofacial surgery in Centerville, Ohio and active in the NPI registry since July 2019. The organization lists Lauren Howard, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1124672092
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NamePROFESSIONAL DENTAL ALLIANCE OF CENTERVILLE, LLC
Location Address9420 DAYTON LEBANON PIKECenterville, OH 45458-3860
Mailing Address11 S Mill St Ste 200New Castle, PA 16101-3680 · (757) 576-5479
Organization SubpartNo
Authorized OfficialLauren HowardCredentialing Specialist · (757) 576-5479
Enumeration DateJuly 30, 2019
NPI 1124672092 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
9420 DAYTON LEBANON PIKE, Centerville, OH 45458

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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.

Dentist (General Practice)
9420 DAYTON LEBANON PIKE
CENTERVILLE, OH 45458
Dentist
9420 DAYTON LEBANON PIKE
CENTERVILLE, OH 45458
Dentist
9420 DAYTON LEBANON PIKE
CENTERVILLE, OH 45458

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 Of Centerville, LLC's NPI number?

The NPI number for Professional Dental Alliance Of Centerville, LLC is 1124672092. It was assigned to this organization in the NPPES registry on July 30, 2019.

Where is Professional Dental Alliance Of Centerville, LLC located?

Professional Dental Alliance Of Centerville, LLC is located at 9420 Dayton Lebanon Pike, Centerville, OH 45458. The listed phone number is (937) 433-8900.

What is Professional Dental Alliance Of Centerville, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Professional Dental Alliance Of Centerville, LLC was last updated on July 30, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.