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Professional Dental Alliance

NPI 1083919252ActiveOrganization· Dentist, General Practice· Boardman, OH

Dentist, General Practice in Boardman, Ohio, registered in NPPES in January 2011, part of Professional Dental Alliance. The authorized official on file is Andrew S. Matta, DMD, Member.

Overview

NPI1083919252
StatusActive
Entity typeOrganization (subpart)
Parent organizationProfessional Dental Alliance
NPI issuedJan 20, 2011
Last updated in NPPESJan 20, 2011

Specialties and licenses

TaxonomyCodeLicenseState
Dentist, General Practice Primary1223G0001X30022469OH

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 4, 2026No match—
New York OMIG · Nov 4, 2026No match—
Ohio Medicaid · Nov 4, 2026No match—
Pennsylvania Medicheck · Nov 4, 2026No match—
Washington HCA · Nov 4, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other Dentist, General Practice providers in Boardman

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