NPIMap

Organization Active NPI

Hyalite Family Dentistry

  • General Practice Dentistry
  • Bozeman, MT
National Provider Identifier
1124237656
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1960 Issued in MT
Legal business name
HYALITE FAMILY DENTISTRY
Practice address
1195 Stoneridge Dr
Suite #1
Bozeman, MT 59718-7048
Phone
(406) 586-4781
Fax
(406) 586-5227
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Eric David Monson, DMDNPI 1881803302
Title
President
Phone
(406) 586-4781

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 1960 MT Primary

Addresses

Primary practice location

1195 Stoneridge Dr
Suite #1
Bozeman, MT 59718-7048

Mailing address

1195 Stoneridge Dr
Suite #1
Bozeman, MT 59718-7048
Phone (406) 586-4781

Other identifiers 2

IdentifierTypeStateIssuer
0005511090MedicaidMT
0000111176MedicaidMT

National Provider Directory

National Provider Directory

Locations

1195 Stoneridge Dr
Ste 1
Bozeman, MT 59718
Phone (406) 586-4781

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124237656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1195 STONERIDGE DR",
            "address_2": "SUITE #1",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597187048",
            "telephone_number": "406-586-4781",
            "fax_number": "406-586-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 STONERIDGE DR",
            "address_2": "SUITE #1",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597187048",
            "telephone_number": "406-586-4781",
            "fax_number": "406-586-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYALITE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MONSON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-586-4781",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "1960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005511090",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000111176",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.