Individual provider Active NPI

Paul Montagna, DDS

  • General Practice Dentistry
  • Angier, NC
National Provider Identifier
1083105977
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11008 Issued in IN
Practice address
15 Rawls Rd Ste 100
Angier, NC 27501-6033
Phone
(919) 639-0264
NPI assigned
May 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11008 IN Primary

Addresses

Primary practice location

15 Rawls Rd Ste 100
Angier, NC 27501-6033

Mailing address

15 Rawls Rd Ste 100
Angier, NC 27501-6033
Phone (919) 639-0264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180926000225 NC Order and Referring Only - DentistPractitioner - Dentist 7911258298

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11008INMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1083105977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 RAWLS RD STE 100",
            "city": "ANGIER",
            "state": "NC",
            "postal_code": "275016033",
            "telephone_number": "919-639-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 RAWLS RD STE 100",
            "city": "ANGIER",
            "state": "NC",
            "postal_code": "275016033",
            "telephone_number": "919-639-0264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAGNA",
        "first_name": "PAUL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-25",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "11008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Angier, NC

Sources for this page

Verify at the official NPI Registry.