Individual provider Active NPI

Ray Montalvo, DMD

  • Dentist
  • Tallahassee, FL
National Provider Identifier
1588096846
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN20331 Issued in FL
Practice address
1970 Gainsborough Drive
Unit 2
Tallahassee, FL 32311
Phone
(850) 765-3040
Fax
(850) 765-3124
NPI assigned
Aug 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN20331 FL Primary

Addresses

Primary practice location

1970 Gainsborough Drive
Unit 2
Tallahassee, FL 32311

Mailing address

1970 Gainsborough Drive
Unit 2
Tallahassee, FL 32311
Phone (850) 765-3040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20150710002305 FL Order and Referring Only - DentistPractitioner - Dentist 8123330644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN20331FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Comfortable Care Dental Health Professionals, P.a. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1588096846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 GAINSBOROUGH DRIVE",
            "address_2": "UNIT 2",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "32311",
            "telephone_number": "850-765-3040",
            "fax_number": "850-765-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 GAINSBOROUGH DRIVE",
            "address_2": "UNIT 2",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "32311",
            "telephone_number": "850-765-3040",
            "fax_number": "850-765-3124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTALVO",
        "first_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-08",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.