Andrea M Montgomery, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5721 Issued in OK

Practice address

725 NW 67TH St
Lawton, OK 73505-4202

Phone

(580) 536-3313

Fax

(580) 536-2011

NPI assigned

Jun 13, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Patrick R. Montgomery, D.D.S.

  • General Practice Dentistry
  • Lawton, OK
  • NPI 1649339862

  General Practice

  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1508860933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 NW 67TH ST",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735054202",
            "telephone_number": "580-536-3313",
            "fax_number": "580-536-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 NW 67TH ST",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735054202",
            "telephone_number": "580-536-3313",
            "fax_number": "580-536-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "ANDREA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200035620A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Shon Monoessy Sr.
• Cindy Monroe
• Morteza Montazeri, M.D.
• Parisa Montazeri, PSY.D.
• Nikki Montes
• Patrick R Montgomery, D.D.S.
• Katherine Jean Moody, R.P.T.
• Sherry Ranee Moody, BSN, RN
• Zenobia Moody
• Emily Olivia Moon, D.C.

• All providers in Lawton, OK
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.