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PROFESSIONAL DENTAL ALLIANCE OF GEORGIA, LLC
NPI 1861900946
Dentist - General Practice in Acworth, GA

Active since January 11, 2018
3466 COBB PKWY NW STE 170, ACWORTH, GA 30101(770) 203-1711(404) 855-4104 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 17, 2018, Feb 23, 2018, Jan 11, 2018 (3 updates tracked since 2018).

About Professional Dental Alliance Of Georgia, Llc NPPES

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

PROFESSIONAL DENTAL ALLIANCE OF GEORGIA, LLC (NPI 1861900946) is a healthcare organization registered as a general practice in Acworth, Georgia and active in the NPI registry since January 2018. The organization maintains 7 additional practice locations and lists Andrew Matta, Owner, as its authorized official.

NPPES Registry Identity

NPI1861900946
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePROFESSIONAL DENTAL ALLIANCE OF GEORGIA, LLC
Location Address3466 COBB PKWY NW STE 170Acworth, GA 30101-5768
Mailing Address11 S Mill StNew Castle, PA 16101-3680
Phone(770) 203-1711
Fax(404) 855-4104
Organization SubpartNo
Authorized OfficialAndrew MattaOwner · (724) 698-2500
Enumeration DateJanuary 11, 2018
Last NPPES UpdateMarch 17, 20183 updates tracked since enumeration
✔ NPI 1861900946 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in GA · DN013474
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.
3466 COBB PKWY NW STE 170, Acworth, GA 30101
Open in Google Maps ↗

Secondary Practice Locations 7

Location 110373 Industrial Blvd NECovington, GA 30014-1403 · Phone (678) 306-6000 · Fax (404) 855-4104
Location 21867 Jonesboro Rd Ste 6McDonough, GA 30253-6099 · Phone (678) 432-0209 · Fax (404) 855-4104
Location 34353 Atlanta Hwy Ste 300Loganville, GA 30052-3232 · Phone (770) 450-2030 · Fax (404) 855-4104
Location 43230 Lawrenceville Suwanee Rd, 300Suwanee, GA 30024 · Phone (724) 698-2500
Location 5740 Ferst Dr NW Suite 207Atlanta, GA 30322-0001 · Phone (404) 733-2022 · Fax (404) 855-4104
Location 64374 Atlanta Hwy Ste 109Hiram, GA 30141-1849 · Phone (770) 505-9898 · Fax (404) 855-4104
Location 75304 Windward Pkwy Ste 107Alpharetta, GA 30004-3828 · Phone (770) 777-1911 · Fax (404) 855-4104

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Other Providers at the Same Location NPPES 2

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

DR. WARREN KRITSANACHAIWANICH DMD
Dentist (General Practice)
3466 COBB PKWY NW STE 170
ACWORTH, GA 30101
Cobb County (770) 203-1711
PDA SPECIALTY OF GEORGIA, LLC
Dentist (Oral and Maxillofacial Pathology)
3466 COBB PKWY NW STE 170
ACWORTH, GA 30101
Cobb County (770) 203-1711

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 Georgia, LLC's NPI number?

The NPI number for Professional Dental Alliance Of Georgia, LLC is 1861900946. It was assigned to this organization in the NPPES registry on January 11, 2018.

Where is Professional Dental Alliance Of Georgia, LLC located?

Professional Dental Alliance Of Georgia, LLC is located at 3466 Cobb Pkwy NW Ste 170, Acworth, GA 30101. The listed phone number is (770) 203-1711.

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

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

What insurance does Professional Dental Alliance Of Georgia, LLC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Professional Dental Alliance Of Georgia, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Professional Dental Alliance Of Georgia, LLC was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.