Edwin Gonzalez Montoya, OMFS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

021002849 Issued in IL

Practice address

6585 E State St
Rockford, IL 61108-2542

Phone

(787) 587-9675

NPI assigned

Oct 7, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1507334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512604800000",
    "number": "1396255097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3618 ELMIRA AVE",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785037724",
            "telephone_number": "787-587-9675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6585 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082542",
            "telephone_number": "787-587-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ MONTOYA",
        "first_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "OMFS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-07",
        "last_updated": "2017-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019031410",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019031410",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "021002849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elena Clare Godfrey, LSW
• Ian J Goldberg, D.O.
• Kaory Gomez-Calzada, DDS
• Rebecca Diane Gomez
• Enrico Gonong, MD
• Alejandro Gonzalez, MS
• Jacqueline Gonzalez
• Nicole Gonzalez
• Good Old Home Care Services
• Kelly Marie Goodwin

• Oral and Maxillofacial Surgery (Dentist) in Rockford, IL
• Providers in Rockford, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2017; 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.