Individual provider Active NPI

Diana Montagu Cline, D.M.D.

  • Endodontics
  • St Augustine, FL
National Provider Identifier
1336575646
Registry record updated Jul 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN21286 Issued in FL
Practice address
2510 US Highway 1 S
Suite B, Attn: Diana Cline
Saint Augustine, FL 32086-6100
Phone
(803) 270-6665
NPI assigned
Sep 18, 2013
Last updated
Jul 27, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DN21286 FL Primary

Addresses

Primary practice location

2510 US Highway 1 S
Suite B, Attn: Diana Cline
Saint Augustine, FL 32086-6100

Mailing address

2510 US Highway 1 S
Suite B, Attn: Diana Cline
Saint Augustine, FL 32086-6100
Phone (803) 270-6665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180801002755 FL Order and Referring Only - DentistPractitioner - Dentist 0143578575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN21286FLMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Montagu Endodontics LLC Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1336575646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 US HIGHWAY 1 S",
            "address_2": "SUITE B, ATTN: DIANA CLINE",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320866100",
            "telephone_number": "803-270-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 US HIGHWAY 1 S",
            "address_2": "SUITE B, ATTN: DIANA CLINE",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320866100",
            "telephone_number": "803-270-6665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINE",
        "first_name": "DIANA",
        "middle_name": "MONTAGU",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-18",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN21286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.