PROFESSIONAL DENTAL ALLIANCE
NPI 1790179992
Dentist in Cleveland, OH

NPI Status: Active since March 25, 2015

Contact Information

11201 SHAKER BLVD
136
CLEVELAND, OH
ZIP 44104
Phone: (216) 368-7238

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  • Organization
  • Dentist

About PROFESSIONAL DENTAL ALLIANCE

This page provides the complete NPI Profile along with additional information for Professional Dental Alliance, a provider established in Cleveland, Ohio operating as a Dentist. The healthcare provider is registered in the NPI registry with number 1790179992 assigned on March 2015. The practitioner's primary taxonomy code is 122300000X with license number 30-023665 (OH). The provider is registered as an organization and their NPI record was last updated 11 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Professional Dental Alliance. The authorized official of this NPI record is Dr. Andrew Matta D.d.s. (Chief Medical Officer)

NPI
1790179992
Provider Legal Name
PROFESSIONAL DENTAL ALLIANCE
Other Organization Name
PROFESSIONAL DENTAL ALLIANCE
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
11201 SHAKER BLVD 136 CLEVELAND, OH 44104
Location Phone
(216) 368-7238
Mailing Address
11 S MILL ST NEW CASTLE, PA 16101
Mailing Phone
(724) 698-2500
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-25-2015
Last Update Date
03-25-2015
Code Navigator

A dentist like Professional Dental Alliance is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist

Taxonomy Code
122300000X
Type
Dental Providers
License No.
30-023665
License State
OH
Taxonomy Description
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. ANDREW MATTA D.D.S.

Authorized Official Title
CHIEF MEDICAL OFFICER
Authorized Official Phone
(724) 674-2965

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
30023665OTHER (01)OHLICENSE NUMBER

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1790179992, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 78. The final step is to find the difference between that total and the next multiple of ten (80 - 78 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
0
Unchanged
Pos 5
1
Doubled → 2
Pos 6
7
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
9
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 1 → 2 9 → 18 → 9 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 8 + 0 + 2 + 7 + 1 + 8 + 9 + 1 + 8 + 24 = 78

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 78 is 80. The difference is the calculated check digit.

80 - 78 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1790179992.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Internal Medicine
11201 SHAKER BLVD, 240
CLEVELAND, OH 44104
Family Medicine
11201 SHAKER BLVD, 240
CLEVELAND, OH 44104
Pediatrics
11201 SHAKER BLVD, STE 338
CLEVELAND, OH 44104
Dentist
11201 SHAKER BLVD
CLEVELAND, OH 44104
Dentist
11201 SHAKER BLVD
CLEVELAND, OH 44104
Internal Medicine
11201 SHAKER BLVD, SUITE 102A
CLEVELAND, OH 44104
Podiatrist (Foot & Ankle Surgery)
11201 SHAKER BLVD, SUITE 240
CLEVELAND, OH 44104
Internal Medicine
11201 SHAKER BLVD, SUITE 328
CLEVELAND, OH 44104
Dentist
11201 SHAKER BLVD, SUITE 136
CLEVELAND, OH 44104
Specialist
11201 SHAKER BLVD, SUITE 130
CLEVELAND, OH 44104
Internal Medicine
11201 SHAKER BLVD, SUITE 102
CLEVELAND, OH 44104
Physician Assistant (Medical)
11201 SHAKER BLVD, SUITE 240
CLEVELAND, OH 44104
Internal Medicine
11201 SHAKER BLVD, SUITE 328
CLEVELAND, OH 44104
Podiatrist (Foot & Ankle Surgery)
11201 SHAKER BLVD, SUITE 240
CLEVELAND, OH 44104
Dentist
11201 SHAKER BLVD, STE. #136
CLEVELAND, OH 44104
Family Medicine
11201 SHAKER BLVD
CLEVELAND, OH 44104
Nurse Practitioner (Adult Health)
11201 SHAKER BLVD, SUITE 328
CLEVELAND, OH 44104
Internal Medicine (Cardiovascular Disease)
11201 SHAKER BLVD, SUITE 240
CLEVELAND, OH 44104
Internal Medicine
11201 SHAKER BLVD, SUITE 240
CLEVELAND, OH 44104
Dentist
11201 SHAKER BLVD, SUITE 136
CLEVELAND, OH 44104

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1790179992, enumerated as an "organization" on March 25, 2015.

The provider is located at 11201 SHAKER BLVD 136 CLEVELAND, OH 44104 and the phone number is (216) 368-7238.

Dentist with taxonomy code 122300000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.