Sutherlin Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D6919 Issued in OR

Legal business name

SUTHERLIN DENTAL

Practice address

115 N State St
Sutherlin, OR 97479-9807

Phone

(541) 459-4612

Fax

(541) 459-4911

NPI assigned

Jan 6, 2009

Organization subpart

No

Name

Dr. Monte' Erell Montgomery, D.D.S.NPI 1164572665

Title

President

Phone

(541) 459-4612

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Monte' Erell Montgomery, DDS

  • General Practice Dentistry
  • Sutherlin, OR
  • NPI 1164572665
  NPD (past) Authorized official

Locations

• Monte' E. Montgomery DDS, PC Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 6, 2009.

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231200000000",
    "number": "1043456403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719",
            "city": "SUTHERLIN",
            "state": "OR",
            "postal_code": "974790719",
            "telephone_number": "541-459-4612",
            "fax_number": "541-459-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N STATE ST",
            "city": "SUTHERLIN",
            "state": "OR",
            "postal_code": "974799807",
            "telephone_number": "541-459-4612",
            "fax_number": "541-459-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTHERLIN DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-06",
        "last_updated": "2009-01-06",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "MONTE'",
        "authorized_official_middle_name": "ERELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-459-4612",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "D6919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monte' E. Montgomery DDS, PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Martin Steele, MD
• Stony Biz LLC
• Sunshine Concepts LLC
• Sutherlin Alf, LLC
• Sutherlin Chiropractic Inc.
• Daisy Tabaldo
• Therapeutic Associates, Inc
• Scott Edward Thomson, RPH
• Toby J. Palm O.D., P.C.
• Umpqua Community Health Center, Inc.

• All providers in Sutherlin, OR
• Dental Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.