Alfonso Gerardo Montillo, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18364 Issued in MA

Practice address

420 Washington St
Suite# 101
Braintree, MA 02184-4755

Phone

(781) 848-2422

Fax

(781) 848-9922

NPI assigned

Sep 2, 2006

Sex

Male

Sole proprietor

Yes

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

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• A. Gerry Montillo DMD PC

  • General Practice Dentistry
  • Braintree, MA
  • NPI 1205115862
  NPD (past)
• Leonard G. Cuscianna DDS

  • Dentist
  • Braintree, MA
  • NPI 1184788424
  NPD (past)

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083716864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 AUSTIN ST",
            "city": "WEST NEWTON",
            "state": "MA",
            "postal_code": "024652501",
            "telephone_number": "617-630-1954",
            "fax_number": "617-969-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 WASHINGTON ST",
            "address_2": "SUITE# 101",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021844755",
            "telephone_number": "781-848-2422",
            "fax_number": "781-848-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTILLO",
        "first_name": "ALFONSO",
        "middle_name": "GERARDO",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "18364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Mitchell
• Ibocwa Phillip Mlongecha
• Molly Pipp LLC
• Elizabeth Monaghan
• Hannah Lee Monroe, MSW
• Makenzie Bridgette Moore
• Shannon Moore, OD
• Kalana K Mordarski, NP
• Lynai C Morelli, COTA/L
• Bailey Elizabeth Morgan

• General Practice Dentistry in Braintree, MA
• Providers in Braintree, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.