New Haven Oral & Maxillofacial Surgery Assoc. PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

4184 Issued in CT

Legal business name

NEW HAVEN ORAL & MAXILLOFACIAL SURGERY ASSOC. PC

Practice address

310 Main St
East Haven, CT 06512-2919

Phone

(203) 468-7181

Fax

(203) 469-8058

NPI assigned

Oct 2, 2007

Last updated

Oct 2, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ronald Richard Montano, D.D.S.

Title

President

Phone

(203) 469-8057

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1437346632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 MAIN ST",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065122919",
            "telephone_number": "203-468-7181",
            "fax_number": "203-469-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 MAIN ST",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065122919",
            "telephone_number": "203-468-7181",
            "fax_number": "203-469-8058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW HAVEN ORAL & MAXILLOFACIAL SURGERY ASSOC. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-02",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "MONTANO",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-469-8057",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "4184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in East Haven, CT
• Providers in East Haven, CT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.