Monticello Dental Center PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MONTICELLO DENTAL CENTER PLLC

Practice address

112 W Bradley St
Star City, AR 71667-5114

Phone

(870) 628-5131

NPI assigned

Dec 15, 2017

Last updated

Feb 15, 2019By 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

Chad D Matone, DDS

Title

Owner/Dentist

Phone

(501) 205-1084

Specialties & licenses 1

Addresses

Other names 1

• Star City Dental Center Other name

Tax ID family

Monticello Dental Center PLLC2 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.

• Monticello Dental Center PLLC

  • General Practice Dentistry
  • Monticello, AR
  • NPI 1346765161
  NPD tax ID

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

{
    "created_epoch": "1513296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550188800000",
    "number": "1578079307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241785",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722230014",
            "telephone_number": "501-205-1084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 W BRADLEY ST",
            "city": "STAR CITY",
            "state": "AR",
            "postal_code": "716675114",
            "telephone_number": "870-628-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTICELLO DENTAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-15",
        "last_updated": "2019-02-15",
        "status": "A",
        "authorized_official_last_name": "MATONE",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "501-205-1084",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Star City Dental Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mainline Health Systems, Inc (Star City High School)
• Mainline Health Systems, Inc (Mainline Center for Healthy Living)
• Mainline Health Systems, Inc. (Jimmy Brown Dental)
• April Summer McGhee, APRN
• Megan Margurette McGriff, SLP
• Monticello Medical Clinic, PLC
• Crystal Lynn Moore, PHARMD
• Krystal Morgan, BS
• N Drew Street Operating LLC
• Kendal Noble, APRN

• General Practice Dentistry in Star City, AR
• Providers in Star City, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2019; 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.