Organization Active NPI

Montagu Endodontics LLC

  • Dentist
  • Jacksonville, FL
National Provider Identifier
1366229676
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MONTAGU ENDODONTICS LLC
Doing business as
Endodontic Partners of Florida
Practice address
5911 Timuquana Rd Ste 101
Jacksonville, FL 32210-8173
Phone
(904) 777-5878
NPI assigned
Sep 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Authorized official

Name
Dr. Diana Cline, DMDNPI 1336575646
Title
Owner
Phone
(803) 270-6665

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

5911 Timuquana Rd Ste 101
Jacksonville, FL 32210-8173

Mailing address

372 Ocean Cay Blvd
Saint Augustine, FL 32080-5891
Phone (803) 270-6665

Other practice location 1

960185 Gateway Blvd Ste 204
Fernandina Beach, FL 32034-7843
Phone (904) 491-6363

Other names 1

  • Endodontic Partners of Florida Doing business as

National Provider Directory

National Provider Directory

Locations

960185 Gateway Blvd
Ste 204
Fernandina Beach, FL 32034
Phone (904) 491-6363

5911 Timuquana Rd
Ste 101
Jacksonville, FL 32210
Phone (904) 777-5878

Practitioners & affiliated clinicians

Practitioners 1

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": "1694390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1366229676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 OCEAN CAY BLVD",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320805891",
            "telephone_number": "803-270-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 TIMUQUANA RD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322108173",
            "telephone_number": "904-777-5878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "960185 Gateway Blvd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Fernandina Beach",
            "state": "FL",
            "postal_code": "320347843",
            "country_code": "US",
            "telephone_number": "904-491-6363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MONTAGU ENDODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "CLINE",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-270-6665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Endodontic Partners of Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.