NPIMap

Organization Active NPI

Molly R Gannon D D S P C

  • General Practice Dentistry
  • Hamilton, MT
National Provider Identifier
1639416738
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2066 Issued in MT
Legal business name
MOLLY R GANNON D D S P C
Practice address
512 Old Corvallis Rd
Hamilton, MT 59840-3131
Phone
(406) 363-1211
Fax
(406) 363-1212
NPI assigned
Jan 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Authorized official

Name
Dr. Molly R Gannon, DDSNPI 1083791784
Title
Owner
Phone
(406) 363-1211

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2066 MT Primary

Addresses

Primary practice location

512 Old Corvallis Rd
Hamilton, MT 59840-3131

Mailing address

512 Old Corvallis Rd
Hamilton, MT 59840-3131
Phone (406) 363-1211

National Provider Directory

National Provider Directory

Locations

512 Old Corvallis Rd
Hamilton, MT 59840
Phone (406) 363-1211

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357689600000",
    "number": "1639416738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 OLD CORVALLIS RD",
            "city": "HAMILTON",
            "state": "MT",
            "postal_code": "598403131",
            "telephone_number": "406-363-1211",
            "fax_number": "406-363-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 OLD CORVALLIS RD",
            "city": "HAMILTON",
            "state": "MT",
            "postal_code": "598403131",
            "telephone_number": "406-363-1211",
            "fax_number": "406-363-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLLY R GANNON D D S P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-09",
        "last_updated": "2013-01-09",
        "status": "A",
        "authorized_official_last_name": "GANNON",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-363-1211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "2066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; 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.