Ryan L Montgomery DDS MD PLLC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

29483 Issued in TX

Legal business name

RYAN L MONTGOMERY DDS MD PLLC

Practice address

3012 Green Meadow Dr
San Angelo, TX 76904-6974

Phone

(325) 944-3565

Fax

(325) 924-8518

NPI assigned

Oct 24, 2015

Organization subpart

No

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

Authorized official

Name

Ryan Montgomery, DDS MDNPI 1679714604

Title

Oral and Maxillofacial Surgeon

Phone

(325) 944-3565

Specialties & licenses 1

Addresses

Other names 1

• Angelo Oral and Maxillofacial Surgery Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan L Montgomery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • San Angelo, TX
  • NPI 1679714604
  NPD (past) Authorized official
• Tony Montgomery, DMD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • San Angelo, TX
  • NPI 1386176782
  NPD (past)

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

{
    "created_epoch": "1445644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445644800000",
    "number": "1477925873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3012 GREEN MEADOW DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046974",
            "telephone_number": "325-944-3565",
            "fax_number": "325-924-8518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3012 GREEN MEADOW DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046974",
            "telephone_number": "325-944-3565",
            "fax_number": "325-924-8518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN L MONTGOMERY DDS MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-24",
        "last_updated": "2015-10-24",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "ORAL AND MAXILLOFACIAL SURGEON",
        "authorized_official_telephone_number": "325-944-3565",
        "authorized_official_credential": "DDS MD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "29483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angelo Oral and Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Harvey D Russwurm, MD
• Nicole Schmoll Russwurm, M.S. CCC-SLP
• Amy Rutherford, M. ED., LPC
• Mallory Rochelle Ryalls
• Kellie Marie Ryan - Wilson, CNM
• Vernon L Ryan, MD
• S. Harding, DDS, P.a.
• Sa-Oms Specialists
• Samantha Sablan, RBT
• Marc Avel Saint Louis, PHARMD

• Oral and Maxillofacial Surgery Clinic/Center in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2015; 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.