MATTHEW WALLA (NPI# 1316227606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316227606 |
| Entity Type | Individual |
| Full Name | MATTHEW WALLA |
| Credential | D.D.S. |
| Practice Address |
3985 Main St Amherst NY 14226-3404 |
| Practice Telephone | 7168321550 |
| Mailing Telephone | 7168321550 |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2011-08-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
055170 | NY | Dental Providers |
| Street Address |
3985 MAIN ST |
| City | AMHERST |
| State | NY |
| Zip Code | 14226-3404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295826634 | Laurence C. Wright, D.d.s., P.C. | Dentist | 3985 Main St, Amherst, NY 14226-3404 | 2006-09-28 |
| 1013178011 | Scott M Farley | Dentist | 3985 Main St, Amherst, NY 14226-3404 | 2008-06-23 |
| 1427149897 | Douglas Finley Wright | Dentist | 3985 Main St, Amherst, NY 14226-3404 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578175089 | Rafael Khavis | Dentist | Dent Tower Suite 401, 3980 Sheridan Drive, Amherst, NY 14226 | 2020-08-18 |
| 1942846209 | Anthony Constance | Occupational Therapist | Excelsior Orthopaedics, 3925 Sheridan Drive, Amherst, NY 14226 | 2019-11-21 |
| 1730743931 | Mark Marcello | Physical Therapy Assistant | 4498 Main/harlem Rd Suite 24, Amherst, NY 14226 | 2019-04-24 |
| 1528531084 | Kimberly Girdlestone | Social Worker | 3960 Harlem Road, Suite 6b, Buffalo, NY 14226 | 2019-01-08 |
| 1043781503 | Justin Patrick Nelson | Physical Therapist | 4498 Main St. Suite 24, Amherst, NY 14226 | 2018-12-10 |
| 1962979195 | Meghan Jim Dougher | Student in an Organized Health Care Education/Training Program | 167 Darwin Dr., Snyder, NY 14226 | 2018-10-25 |
| 1790260982 | Orchard Park Dentalcare Pllc | Clinic/Center | 3302 Sheridan Dr, Buffalo, NY 14226 | 2018-10-03 |
| 1619472719 | Rapha Family Medical Wellness PC | Family Medicine | 3610 Main Street, Amherst, NY 14226 | 2018-03-29 |
| 1790299832 | Medical Ecp of Western New York P C | Internal Medicine | 4330 Maple Rd Ste 102, Amherst, NY 14226 | 2017-11-28 |
| 1841709425 | Elisabeth Wagner | Physical Therapy Assistant | 4498 Main St., Suite 24, Amherst, NY 14226 | 2017-09-26 |
| Find all providers in zip 14226 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023657681 | Orthodontics Too, Pllc | Dentist | 7 State Route 101a Unit D, Amherst, NH 03031-3132 | 2019-12-31 |
| 1700110335 | Sawsan Tabbaa | Dentist | 129 Landings Dr, Amherst, NY 14228-1488 | 2009-09-29 |
| 1235340126 | Amherst Orthodontics | Dentist | 5 Overlook Dr, Suite 6, Amherst, NH 03031-2831 | 2007-05-24 |
| 1295826634 | Laurence C. Wright, D.d.s., P.C. | Dentist | 3985 Main St, Amherst, NY 14226-3404 | 2006-09-28 |
| 1619984515 | Robert S Bavisotto | Dentist | 2005 Niagara Falls Blvd, Amherst, NY 14228-3520 | 2006-08-02 |
| 1619413721 | Brian Kurtzner | Dentist | 3476 Sheridan Dr, Amherst, NY 14226-1545 | 2017-01-12 |
| 1841422110 | Even Diane Shieh | Dentist | 5 Overlook Dr, Suite #6, Amherst, NH 03031-2831 | 2009-08-19 |
| 1518199934 | Deborah A Deberadinis | Dentist | 5 Overlook Dr, Suite #6, Amherst, NH 03031-2831 | 2009-08-18 |
| 1013178011 | Scott M Farley | Dentist | 3985 Main St, Amherst, NY 14226-3404 | 2008-06-23 |
| 1366617250 | Suburban Orthodontics | Dentist | 2005 Niagara Falls Blvd, Amherst, NY 14228-3520 | 2008-04-23 |
| Find all providers in AMHERST | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.