Active NPI
Jessica E Mongelli, DMD
- Dentist
- Helena, MT
National Provider Identifier
1639212947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2160
- Practice address
- 1093 Helena Avenue
Helena, MT 59601-3558 - Phone
- (406) 442-5930
- Fax
- (406) 442-5931
- NPI assigned
- Feb 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2160 | MT | Primary |
Addresses
Primary practice location
1093 Helena Avenue
Helena, MT 59601-3558
Mailing address
1093 Helena Avenue
Helena, MT 59601-3558
Phone (406) 442-5930
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0113322 | Medicaid | MT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160209000663 | MT | Order and Referring Only - Dentist | 3476857657 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2160 | MT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639212947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1093 HELENA AVENUE",
"city": "HELENA",
"state": "MT",
"postal_code": "596013558",
"telephone_number": "406-442-5930",
"fax_number": "406-442-5931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1093 HELENA AVENUE",
"city": "HELENA",
"state": "MT",
"postal_code": "596013558",
"telephone_number": "406-442-5930",
"fax_number": "406-442-5931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONGELLI",
"first_name": "JESSICA",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MT",
"license": "2160",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0113322",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Helena, MT
- Jackie F Mohler
- Alexis Carol Molineux-Gibbons, MA, CCC-SLP
- Mary Anne Molineux, M.A.
- Michael Christopher Mondloch, MD
- Summer Elizabeth Monforte, M.D.
- Montana Behavior Collaborative, PLLC
- Montana Children'S Home & Hospital
- Montana Children'S Home & Hospital
- Montana Children'S Home & Hospital
- Montana Children'S Home & Hospital
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.