NPIMap

Organization Active NPI

Progressive Dental of Montrose, LLC

  • General Practice Dentistry
  • Montrose, PA
National Provider Identifier
1447548854
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PROGRESSIVE DENTAL OF MONTROSE, LLC
Practice address
57 Public Ave
Montrose, PA 18801-1219
Phone
(570) 278-1186
Fax
(570) 278-1873
NPI assigned
Jul 19, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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

Authorized official

Name
Mr. Michael J Dean
Title
Business Manager
Phone
(607) 754-2273

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X PA Primary

Addresses

Primary practice location

57 Public Ave
Montrose, PA 18801-1219

Mailing address

57 Public Ave
Montrose, PA 18801-1219
Phone (570) 278-1186

National Provider Directory

National Provider Directory

Locations

57 Public Ave
Montrose, PA 18801
Phone (570) 278-1186

NPI Registry JSON

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311033600000",
    "number": "1447548854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 PUBLIC AVE",
            "city": "MONTROSE",
            "state": "PA",
            "postal_code": "188011219",
            "telephone_number": "570-278-1186",
            "fax_number": "570-278-1873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 PUBLIC AVE",
            "city": "MONTROSE",
            "state": "PA",
            "postal_code": "188011219",
            "telephone_number": "570-278-1186",
            "fax_number": "570-278-1873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE DENTAL OF MONTROSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-07-19",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "607-754-2273",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; 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.