Monticello Family Dental Care LLC

Primary specialty

DentistTaxonomy code 122300000X

License

5420 Issued in LA

Legal business name

MONTICELLO FAMILY DENTAL CARE LLC

Practice address

4814 Monticello Blvd
Baton Rouge, LA 70814

Phone

(225) 275-4665

Fax

(225) 274-8906

NPI assigned

Nov 16, 2012

Last updated

Nov 16, 2012By 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

Mr. Thuong - Tri Dinh Nguyen, D.D.S.NPI 1689750887

Title

Owner

Phone

(225) 275-4665

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Thuong-Tri Dinh Nguyen, DDS

  • Dentist
  • Baton Rouge, LA
  • NPI 1689750887
  NPD (past) Authorized official
• Thuy-Anh Kiev Bui, DDS

  • Dentist
  • Baton Rouge, LA
  • NPI 1356438923
  NPD (past)

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

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353024000000",
    "number": "1568706422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4814 MONTICELLO BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70814",
            "telephone_number": "225-275-4665",
            "fax_number": "225-274-8906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4814 MONTICELLO BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70814",
            "telephone_number": "225-275-4665",
            "fax_number": "225-274-8906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTICELLO FAMILY DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-16",
        "last_updated": "2012-11-16",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "THUONG - TRI",
        "authorized_official_middle_name": "DINH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-275-4665",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "5420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1854204",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jo'Ann Lynette Montgomery, LPN
• Kimberly A. Montgomery, RN, CDE
• Lael Montgomery, CAC
• Larry Lee Montgomery, M.D.
• Theresa S Montgomery, PHARMD
• Destiny Montiville
• Ngozi Monu, NP
• Delissia Moody
• Devan Blaine Moody, M.D.
• Jason Mook

• Dentist in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Dentist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; 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.