NPIMap

Organization Active NPI

Montoya Pediatric Dentistry LLC Dba San Tan Pediatric Dental

  • Pediatric Dentistry
  • Queen Creek, AZ
National Provider Identifier
1467607218
Registry record updated Nov 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
7384 Issued in AZ
Legal business name
MONTOYA PEDIATRIC DENTISTRY LLC DBA SAN TAN PEDIATRIC DENTAL
Practice address
2510 E Hunt Hwy
Ste. 29
Queen Creek, AZ 85243-5206
Phone
(480) 457-1693
Fax
(480) 457-1321
NPI assigned
Nov 20, 2008
Last updated
Nov 21, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2008

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

Authorized official

Name
Stephen J Montoya, D.D.S.NPI 1407045636
Title
Owner/Dentist
Phone
(480) 457-1693

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
Pediatric Dentistry 1223P0221X 7384 AZ Primary

Addresses

Primary practice location

2510 E Hunt Hwy
Ste. 29
Queen Creek, AZ 85243-5206

Mailing address

2510 E Hunt Hwy
Ste. 29
Queen Creek, AZ 85243-5206
Phone (480) 457-1693

Other identifiers 1

IdentifierTypeStateIssuer
1407045636MedicaidAZ

National Provider Directory

National Provider Directory
Tax ID family
Montoya Pediatric Dentistry LLC Dba San Tan Pediatric Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2510 E Hunt Hwy
Ste 29
San Tan Valley, AZ 85143
Phone (480) 457-1693

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": "1227139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227225600000",
    "number": "1467607218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 E HUNT HWY",
            "address_2": "STE. 29",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "852435206",
            "telephone_number": "480-457-1693",
            "fax_number": "480-457-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 E HUNT HWY",
            "address_2": "STE. 29",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "852435206",
            "telephone_number": "480-457-1693",
            "fax_number": "480-457-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTOYA PEDIATRIC DENTISTRY LLC DBA SAN TAN PEDIATRIC DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-20",
        "last_updated": "2008-11-21",
        "status": "A",
        "authorized_official_last_name": "MONTOYA",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "480-457-1693",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "7384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407045636",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2008; 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.