Michael C. Montgomery D.M.D.,P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

DN010347 Issued in GA

Legal business name

MICHAEL C. MONTGOMERY D.M.D.,P.C.

Practice address

1040 Barclay Dr
Madison, GA 30650-4621

Phone

(706) 342-1242

NPI assigned

Jan 25, 2007

Last updated

Aug 22, 2020By 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

Michael Clinton Montgomer, D.M.D.

Title

Owner Operator

Phone

(706) 342-1242

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508911793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 BARCLAY DR",
            "city": "MADISON",
            "state": "GA",
            "postal_code": "306504621",
            "telephone_number": "706-342-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 BARCLAY DR",
            "city": "MADISON",
            "state": "GA",
            "postal_code": "306504621",
            "telephone_number": "706-342-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL C. MONTGOMERY D.M.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MONTGOMER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "CLINTON",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "706-342-1242",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN010347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00351843A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100805",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9183572",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inez Almeida McDaniel, LPC
• Davis Edward McHugh
• Medical Outreach Services of Madison PC
• Medics Home Health Services, Inc
• Sergio T Mejias, MD
• Miguel E. Cossio M.D., P.C.
• Michael Clinton Montgomery, D.M.D.,P.C.
• Moore Health Inc. (DBA Moore Pharmacy)
• Edmetris Moore-Donald
• William David Moore Sr., RPH

• Dentist in Madison, GA
• Providers in Madison, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.