Professional Dental Alliance
Professional Dental Alliance is a healthcare organization registered as General Practice Dentistry in Boardman, OH, holding Type 2 (organization) NPI 1083919252 since 2011. The authorized official on file is Andrew Matta, Member.
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| NPI | 1083919252 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Professional Dental Alliance |
| Parent organization | Professional Dental Alliance |
| Practice address | 99 DEBARTOLO PL, Boardman, OH, 44512 |
| Phone | 3307582348 |
| Fax | 3305332700 |
| Enumeration date | 2011-01-20 |
| Last updated in NPPES | 2011-01-20 |
Authorized official
| Name | Andrew Matta |
|---|---|
| Title | Member |
| Phone | 3305333400 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 1223G0001X | General Practice Dentistry | Primary | 30022469 | OH |
Copy-ready billing details
Provider: Professional Dental Alliance NPI: 1083919252 Taxonomy: 1223G0001X (General Practice Dentistry) Address: 99 DEBARTOLO PL, Boardman, OH, 44512
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1811093545 | David A Wyatt, DDS, Lls | Organization | Dentist | Boardman, OH |
| 1881760148 | Chad Wise | Individual | Dentist | Boardman, OH |
| 1902081276 | David Wyatt | Individual | Dentist | Boardman, OH |
Verify this record
Cross-check NPI 1083919252 against the authoritative CMS record: view Professional Dental Alliance on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is the NPI number for Professional Dental Alliance?
Who is the authorized official for Professional Dental Alliance?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2011-01-20.