Richard John Montandon, D.D.S.

Primary specialty

Dental AnesthesiologyTaxonomy code 1223D0004X

License

GA60690773 Issued in WA

Practice address

1859 N Lakewood Dr Ste 101
Coeur D Alene, ID 83814-2661

Phone

(208) 818-6527

NPI assigned

Jun 29, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rmontandon1206025@wm.providencedirect.org

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.

• Providence Health & Services Washington

  • Pulmonary Disease Physician
  • Spokane, WA
  • NPI 1194099390
  Medicare reassignment NPD
• Providence Health & Services - Washington

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Hoquiam, WA
  • NPI 1043374119
  NPD (past)

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1164650198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1859 N LAKEWOOD DR STE 101",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142661",
            "telephone_number": "208-818-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1859 N LAKEWOOD DR STE 101",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142661",
            "telephone_number": "208-818-6527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 W 8th Ave Ste 123C",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992042302",
            "country_code": "US",
            "telephone_number": "509-474-7498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTANDON",
        "first_name": "RICHARD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-29",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60688067",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "PA",
            "license": "DS039119",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "WA",
            "license": "GA60690773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmontandon1206025@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "105 W 8th Ave Ste 123C",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992042302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephanie Mokry, B.S. CADC
• Stephanie Rose Moline, M.D.
• Monarch Counseling Services
• Monarch Mental Health
• Monarch Mental Health, LLC
• Shari Vandyke Montandon, D.O.
• Jackson Montani
• Brittany Montgomery, LMSW
• Rebecca Elizabeth Montgomery
• David Ernest Moody, MD

• Dental Anesthesiology in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Dental Anesthesiology in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.