Healthcare Provider Details

I. General information

NPI: 1790698645
Provider Name (Legal Business Name): SUNSHINE URGENT DENTAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6789 RIDGE RD STE 301
PARMA OH
44129-5635
US

IV. Provider business mailing address

6789 RIDGE RD STE 301
PARMA OH
44129-5635
US

V. Phone/Fax

Practice location:
  • Phone: 440-334-9684
  • Fax: 440-334-9684
Mailing address:
  • Phone: 440-334-9684
  • Fax: 440-334-9684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW T NOGLE
Title or Position: OWNER/PROVIDER
Credential: DDS
Phone: 440-334-9684