NPIMap

Organization Active NPI

Queen City Dental Studio

  • Dentist
  • Helena, MT
National Provider Identifier
1346691201
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2386 Issued in MT
Legal business name
QUEEN CITY DENTAL STUDIO
Practice address
1300 N. Montana Ave
Helena, MT 59601
Phone
(406) 449-1300
Fax
(406) 449-1311
NPI assigned
Jun 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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

Authorized official

Name
Dr. Charissa Michelle Martin, DDS
Title
Dentist/Owner
Phone
(406) 449-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 2386 MT Primary

Addresses

Primary practice location

1300 N. Montana Ave
Helena, MT 59601

Mailing address

1300 N Montana Ave
Helena, MT 59601-3507
Phone (406) 461-4445

National Provider Directory

National Provider Directory

Locations

1300 N Montana Ave
Helena, MT 59601
Phone (406) 449-1300

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": "1466553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575590400000",
    "number": "1346691201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N MONTANA AVE",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596013507",
            "telephone_number": "406-461-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N. MONTANA AVE",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "59601",
            "telephone_number": "406-449-1300",
            "fax_number": "406-449-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEEN CITY DENTAL STUDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-22",
        "last_updated": "2019-12-06",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "CHARISSA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "406-449-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MT",
            "license": "2386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Helena, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; 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.