PROFESSIONAL DENTAL ALLIANCE
NPI 1790179992
Dentist in Cleveland, OH

Q: What is Professional Dental Alliance's NPI number?

The NPI number for Professional Dental Alliance is 1790179992. It was assigned to this organization in the NPPES registry on March 25, 2015.

Q: What is Professional Dental Alliance's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Active since March 25, 2015

11201 SHAKER BLVD, 136, CLEVELAND, OH 44104(216) 368-7238 Get Directions Write a Review

NPPES record last updated: March 25, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Professional Dental Alliance NPPES

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

PROFESSIONAL DENTAL ALLIANCE (NPI 1790179992) is a healthcare organization registered as a dentist in Cleveland, Ohio and active in the NPI registry since March 2015. The organization lists Andrew Matta, Chief Medical Officer, as its authorized official.

NPPES Registry Identity

NPI1790179992

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NamePROFESSIONAL DENTAL ALLIANCE

Location Address11201 SHAKER BLVD, 136Cleveland, OH 44104-3869

Mailing Address11 S Mill StNew Castle, PA 16101-3613 · (724) 698-2500

Phone(216) 368-7238

Organization SubpartNo

Authorized OfficialAndrew MattaChief Medical Officer · (724) 674-2965

Enumeration DateMarch 25, 2015

✔ NPI 1790179992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in OH · 30-023665

Definition

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.

11201 SHAKER BLVD, Cleveland, OH 44104

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Other Names 1

Doing Business AsProfessional Dental Alliance

Other Identifiers 1

Other30023665OH · License Number

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 20

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

CLEVELAND DENTAL INSTITUTE LLC

Clinic/Center (Dental)

11201 SHAKER BLVD
CLEVELAND, OH 44104

Cuyahoga County (216) 368-7238

SCOTT R BARTL PAC

Physician Assistant (Medical)

11201 SHAKER BLVD, SUITE 240
CLEVELAND, OH 44104

Cuyahoga County (216) 791-0017

MABEL BURGOS

Case Manager/Care Coordinator

11201 SHAKER BLVD
CLEVELAND, OH 44104

Cuyahoga County (216) 417-8813

DIAMOND E CHERRY

Case Manager/Care Coordinator

11201 SHAKER BLVD
CLEVELAND, OH 44104

Cuyahoga County (216) 417-8813

DR. CARRIE A BASSETT D.O.

Internal Medicine

11201 SHAKER BLVD, SUITE 102A
CLEVELAND, OH 44104

Cuyahoga County (216) 721-6900

CAROL RANGE

Case Manager/Care Coordinator

11201 SHAKER BLVD
CLEVELAND, OH 44104

Cuyahoga County (216) 417-8813

MALIKIA DECTRICE CALHOUN

Case Manager/Care Coordinator

11201 SHAKER BLVD
CLEVELAND, OH 44104

Cuyahoga County (440) 752-7810

SINCERE CARE LLC

Day Training, Developmentally Disabled Services

11201 SHAKER BLVD, STE 334/336
CLEVELAND, OH 44104

Cuyahoga County (216) 347-7377

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 1790179992. It was assigned to this organization in the NPPES registry on March 25, 2015.

Where is Professional Dental Alliance located?

Professional Dental Alliance is located at 11201 Shaker Blvd 136, Cleveland, OH 44104. The listed phone number is (216) 368-7238.

What is Professional Dental Alliance's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Professional Dental Alliance was last updated on March 25, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.