Montana Childrens Dentistry PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MONTANA CHILDRENS DENTISTRY PLLC

Practice address

116 Glacier Dr Ste 107
Lolo, MT 59847-9343

Phone

(702) 339-7274

NPI assigned

Dec 7, 2021

Last updated

Dec 7, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Steven Delisle, DDSNPI 1639329337

Title

Owner

Phone

(702) 339-7274

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Steven Eliot Delisle, DDS

  • Dentist
  • Lolo, MT
  • NPI 1639329337
  NPD Authorized official

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638835200000",
    "number": "1326706201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 GLACIER DR STE 107",
            "city": "LOLO",
            "state": "MT",
            "postal_code": "598479343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 GLACIER DR STE 107",
            "city": "LOLO",
            "state": "MT",
            "postal_code": "598479343",
            "telephone_number": "702-339-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTANA CHILDRENS DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-07",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A",
        "authorized_official_last_name": "DELISLE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-339-7274",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dan McFarland
• Kevin John Louis McHugh, PT, DPT
• Sadie McKay, PCLC
• McKayla McNamara
• Heather Miller, LCPC
• Montana Migrant and Seasonal Farmworkers Council, Inc.
• Greg Murray, PA-C
• Kira Pecarina, PTA
• Ross William Roadarmel, PHARM D
• Robert Dean Wilcox (Lolo Drug)

• Dentist in Lolo, MT
• Providers in Lolo, MT by specialty
• Dentist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.