Active NPI
Erin Maille Montano, D.D.S.
- Dentist
- Gallup, NM
National Provider Identifier
1114281508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD3697
- Practice address
- 802 US Highway 491
Gallup, NM 87301-5388 - Phone
- (505) 862-5018
- NPI assigned
- Jun 29, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DD3697 | NM | Primary |
Addresses
Primary practice location
802 US Highway 491
Gallup, NM 87301-5388
Mailing address
1506 Diamond Cir
Gallup, NM 87301-4900
Phone (314) 409-4009
Other practice location 1
501 E Nizhoni Blvd
Gallup, NM 87301-5757
Phone (505) 863-9363
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DD3697 | NM | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Silas Porter, LLC | Past | Accepting new patients | |
| Tasker Hatch Rowan LLC | Dentist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dentist
- Gallup, NM
- NPI 1013353127
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553558400000",
"number": "1114281508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1506 DIAMOND CIR",
"city": "GALLUP",
"state": "NM",
"postal_code": "873014900",
"telephone_number": "314-409-4009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "802 US HIGHWAY 491",
"city": "GALLUP",
"state": "NM",
"postal_code": "873015388",
"telephone_number": "505-862-5018"
}
],
"practiceLocations": [
{
"address_1": "501 E Nizhoni Blvd",
"address_purpose": "LOCATION",
"city": "Gallup",
"state": "NM",
"postal_code": "873015757",
"country_code": "US",
"telephone_number": "505-863-9363",
"fax_number": "505-863-2554",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MONTANO",
"first_name": "ERIN",
"middle_name": "MAILLE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-29",
"last_updated": "2019-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DD3697",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gallup, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.