Monte Page Family Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D3606 Issued in ID

Legal business name

MONTE PAGE FAMILY DENTISTRY

Practice address

135 Warren Ave
Pocatello, ID 83201-4621

Phone

(208) 237-6453

Fax

(208) 233-4227

NPI assigned

Oct 12, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Richard Lamonte Page, D.M.D.

Title

President

Phone

(208) 237-6453

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Smiles by Design Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1053400580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 WARREN AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014621",
            "telephone_number": "208-237-6453",
            "fax_number": "208-233-4227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 WARREN AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014621",
            "telephone_number": "208-237-6453",
            "fax_number": "208-233-4227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTE PAGE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "PAGE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "LAMONTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-237-6453",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806402100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smiles by Design",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Diane K. Moll
• Mary Paul Moller, LMFT
• Danielle Molsee, LMSW
• Misty Dawn Moniz, LMSW
• Gabe Monroe, PA-C
• Clarice Montecalvo, M.D.
• Jason Montgomery, NP-C
• Hannah Montrose
• Megan Moon
• Jessica R Mooney, DPT

• General Practice Dentistry in Pocatello, ID
• Providers in Pocatello, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; 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.