NPIMap

Organization Active NPI

Tate Montgomery DDS PLC

Doing business as Heartland Anesthesia

  • Dentist
  • Sapulpa, OK
National Provider Identifier
1396090791
Registry record updated Jul 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6231 Issued in OK
Legal business name
TATE MONTGOMERY DDS PLC
Doing business as
Heartland Anesthesia
Practice address
911 N Ridgeway St
Sapulpa, OK 74066-2417
Phone
(918) 200-9610
Fax
(918) 200-9610
NPI assigned
Jul 22, 2012
Last updated
Jul 22, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2012

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

Authorized official

Name
Dr. Tate Montgomery, DDSNPI 1255575502
Title
Owner
Phone
(918) 200-9610

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 6231 OK Primary

Addresses

Primary practice location

911 N Ridgeway St
Sapulpa, OK 74066-2417

Mailing address

911 N Ridgeway St
Sapulpa, OK 74066-2417
Phone (918) 200-9610

Other names 1

  • Heartland Anesthesia Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1342915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342915200000",
    "number": "1396090791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 N RIDGEWAY ST",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740662417",
            "telephone_number": "918-200-9610",
            "fax_number": "918-200-9610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 N RIDGEWAY ST",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740662417",
            "telephone_number": "918-200-9610",
            "fax_number": "918-200-9610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TATE MONTGOMERY DDS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-22",
        "last_updated": "2012-07-22",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "TATE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-200-9610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OK",
            "license": "6231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heartland Anesthesia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sapulpa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2012; 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.