Vincent Montgomery, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

118 Issued in OK

Practice address

3727 NW 63Rd St
Suite 300
Oklahoma City, OK 73116-1931

Phone

(405) 292-2390

Fax

(405) 292-2393

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 21, 2016 through Jun 21, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Oral and Maxillofacial Associates

  • Oral and Maxillofacial Pathology Dentistry
  • Oklahoma City, OK
  • NPI 1932281268
  NPD (past)
• Oral and Maxillofacial Surgery Associates Oklahoma PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Oklahoma City, OK
  • NPI 1467591339
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1598846768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3727 NW 63RD ST",
            "address_2": "SUITE 300",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731161931",
            "telephone_number": "405-848-7994",
            "fax_number": "405-879-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3727 NW 63RD ST",
            "address_2": "SUITE 300",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731161931",
            "telephone_number": "405-292-2390",
            "fax_number": "405-292-2393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "VINCENT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OK",
            "license": "118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lenora Montgomery, MBA
• Madinah Montgomery
• Mindy Beth Montgomery, BHRS
• Paula Jean Montgomery, PHYSICIAN ASSOCIATE
• Vilynsia Lajuana Montgomery, LPC
• Willie Montgomery
• Agueda Lizbeth Montoya
• Brianna Montoya
• Cynthia A Montoya
• Kenya Sarahi Montoya

• Oral and Maxillofacial Surgery (Dentist) in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Oral and Maxillofacial Surgery (Dentist) in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.