NPIMap

Organization Active NPI

Facial Plastic and Reconstructive Surgery Montana PC

Doing business as Cosmetic Surgical Arts Center

  • Clinic/Center
  • Missoula, MT
National Provider Identifier
1407116338
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
FACIAL PLASTIC AND RECONSTRUCTIVE SURGERY MONTANA PC
Doing business as
Cosmetic Surgical Arts Center
Practice address
805 S Reserve St
Missoula, MT 59801-2104
Phone
(406) 549-6600
Fax
(406) 549-1511
NPI assigned
May 25, 2012
Last updated
Apr 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Authorized official

Name
Dr. RF John Holtzen, DMD
Title
Owner
Phone
(406) 549-6600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Ambulatory Surgical Clinic/Center 261QA1903X 12580 MT

Addresses

Primary practice location

805 S Reserve St
Missoula, MT 59801-2104

Mailing address

805 S Reserve St
Missoula, MT 59801-2104
Phone (406) 549-6600

Other identifiers 1

IdentifierTypeStateIssuer
60882OtherMTBLUE CROSS BLUE SHIELD

Other names 1

  • Cosmetic Surgical Arts Center 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": "1337904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745280000000",
    "number": "1407116338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 S RESERVE ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598012104",
            "telephone_number": "406-549-6600",
            "fax_number": "406-549-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 S RESERVE ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598012104",
            "telephone_number": "406-549-6600",
            "fax_number": "406-549-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACIAL PLASTIC AND RECONSTRUCTIVE SURGERY MONTANA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-25",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "HOLTZEN",
        "authorized_official_first_name": "RF JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-549-6600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MT",
            "license": "12580",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "60882",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cosmetic Surgical Arts Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.