Michael Momchev, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019036224 Issued in IL

Practice address

6712 N Mountello Dr
Peoria, IL 61614-2328

Phone

(309) 691-7855

NPI assigned

Jul 2, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Smalltown Dental Willow Knolls LLC

  • General Practice Dentistry
  • Peoria, IL
  • NPI 1699365809
  NPD
• Richard T. Moon, D.D.S., P.C.

  • General Practice Dentistry
  • Peoria, IL
  • NPI 1093931784
  NPD (past)

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

{
    "created_epoch": "1751414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1063301000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S 4TH AVE STE 110",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615503401",
            "telephone_number": "309-370-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6712 N MOUNTELLO DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142328",
            "telephone_number": "309-691-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMCHEV",
        "first_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-02",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019036224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Lincoln Mock, LCSW
• Zohra F Moeenuddin, M.D.
• Lynna Moenga
• Maryam Moin, M.D.
• Sherry Lee Molburg, MSW
• Moments Hospice of Peoria LLC
• Lisa Monagle, RDN
• Jacqueline Doris Monckton
• Shannon Leigh Monckton, PTA
• Jamie Monier, SLP

• General Practice Dentistry in Peoria, IL
• Providers in Peoria, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.