Susan Wright Mongeau, DDS, MPH

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

DN010346 Issued in GA

Practice address

2200 Bergquist Dr Ste 1
Lackland AFB, TX 78236-9908

Phone

(210) 925-1846

NPI assigned

Nov 14, 2008

Last updated

Nov 14, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1226620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226620800000",
    "number": "1073767117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR STE 1",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782369908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR STE 1",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "210-925-1846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONGEAU",
        "first_name": "SUSAN",
        "middle_name": "WRIGHT",
        "name_prefix": "Dr.",
        "credential": "DDS, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-14",
        "last_updated": "2008-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "GA",
            "license": "DN010346",
            "primary": true
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "FL",
            "license": "DN11320",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominique Blancett Mercado, PA
• Stephen Elliott Messier, MD
• Bryan P Meyenberg, ATC, LAT
• Alisa Anne Miller, D.O.
• Noah Marcus Miller, D.M.D
• Miguel A Montalvo, M.D.
• Song Jun Moon, PA-C
• Rachel Anne Mooney, DDS
• Mysti Moore, PT
• Jeffrey D Morgan, M.D.

• Public Health Dentistry in Lackland AFB, TX
• Providers in Lackland AFB, TX by specialty
• Public Health Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.