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PROFESSIONAL DENTAL ALLIANCE OF KETTERING, LLC
NPI 1558915322
Dentist - Oral and Maxillofacial Surgery in Kettering, OH

Active since July 30, 2019
4055 FAR HILLS AVE, KETTERING, OH 45429(937) 299-3691 Get Directions Write a Review

NPPES record last updated: July 30, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Professional Dental Alliance Of Kettering, Llc NPPES

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

PROFESSIONAL DENTAL ALLIANCE OF KETTERING, LLC (NPI 1558915322) is a healthcare organization registered as an oral and maxillofacial surgery in Kettering, Ohio and active in the NPI registry since July 2019. The organization lists Lauren Howard, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1558915322
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NamePROFESSIONAL DENTAL ALLIANCE OF KETTERING, LLC
Location Address4055 FAR HILLS AVEKettering, OH 45429-2440
Mailing Address11 S Mill St Ste 200New Castle, PA 16101-3680 · (757) 576-5479
Phone(937) 299-3691
Organization SubpartNo
Authorized OfficialLauren HowardCredentialing Specialist · (757) 576-5479
Enumeration DateJuly 30, 2019
✔ NPI 1558915322 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.
4055 FAR HILLS AVE, Kettering, OH 45429
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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 4

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

STEPHANIE S. KERR CDA
Dental Assistant
4055 FAR HILLS AVE
KETTERING, OH 45429
Montgomery County (937) 299-3691
PROFESSIONAL DENTAL ALLIANCE OF KETTERING, LLC
Dentist
4055 FAR HILLS AVE
KETTERING, OH 45429
Montgomery County (877) 959-5405
DR. PATRICK JAMES KIGGINS D.D.S.
Dentist (General Practice)
4055 FAR HILLS AVE
KETTERING, OH 45429
Montgomery County (937) 299-3691
J CLARKE SANDERS DDS KETTERING LLC
Dentist
4055 FAR HILLS AVE
KETTERING, OH 45429
Montgomery County (877) 959-5405

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 Kettering, LLC's NPI number?

The NPI number for Professional Dental Alliance Of Kettering, LLC is 1558915322. It was assigned to this organization in the NPPES registry on July 30, 2019.

Where is Professional Dental Alliance Of Kettering, LLC located?

Professional Dental Alliance Of Kettering, LLC is located at 4055 Far Hills Ave, Kettering, OH 45429. The listed phone number is (937) 299-3691.

What is Professional Dental Alliance Of Kettering, 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 Kettering, 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.