Randall Cline Montgomery, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4805 Issued in TN

Practice address

2975 Fort Henry Dr
Kingsport, TN 37664-4005

Phone

(423) 247-9196

NPI assigned

Dec 13, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1255316154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2975 FORT HENRY DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376644005",
            "telephone_number": "423-247-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2975 FORT HENRY DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376644005",
            "telephone_number": "423-247-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "RANDALL",
        "middle_name": "CLINE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "4805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MMDS, LLC (Stat Xrays)
• Eric David Moffet, MD
• Jennifer Leigh Mongold, MA
• Amy R Monroe, DPT
• Callie Darlene Montgomery, F.N.P.
• Leah Nicole Moon, MD
• Soon Moon, DO
• Mary Rebecca Mooney, PT
• Candeda Sha Moore, PHARMD
• Christy L Moore, NP

• General Practice Dentistry in Kingsport, TN
• Providers in Kingsport, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.