Carlos Santana Montalvo, IDC

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

31862 Issued in CA

Practice address

2700 Adams Ave Ste 209
San Diego, CA 92116-1367

Phone

(619) 647-4599

Fax

(888) 323-3119

NPI assigned

May 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• Affordable Crowns

  • Dental Clinic/Center
  • San Diego, CA
  • NPI 1669043618
  NPD

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1114133113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 ADAMS AVE STE 209",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921161367",
            "telephone_number": "619-647-4599",
            "fax_number": "888-323-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 ADAMS AVE STE 209",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921161367",
            "telephone_number": "619-647-4599",
            "fax_number": "888-323-3119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4508 Timken Trl",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761376144",
            "country_code": "US",
            "telephone_number": "817-782-5914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTALVO",
        "first_name": "CARLOS",
        "middle_name": "SANTANA",
        "name_prefix": "Mr.",
        "credential": "IDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "31862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF DENTAL HYGIENE CALIFORNIA",
            "identifier": "31862",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alvin Ollada Montalbo, IDC
• Jahzel Montalla
• Brittany R Montalvan
• Maria Guadalupe Montalvan, MFT INTERN
• Lucy D Montalvo-Hicks, MD,MPH
• Kristin Lynn Montalvo, M.D.
• Stephanie Montanarelli
• Ruben Alexander Montane, DC
• Christina Montanez
• Jena Montanez, BCBA

• Dental Hygienist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dental Hygienist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.