Melanie Rose Watson-Montgomery, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

432080709 Issued in IL

Practice address

3330 W 177TH St
Unit 1-G
Hazel Crest, IL 60429-2186

Phone

(708) 798-7400

Fax

(708) 798-7503

NPI assigned

Sep 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwatson3@direct.ccprovider.org

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.

• Cook County

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1588612832
  Medicare reassignment NPD
• Cook County

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1821385170
  NPD
• Cook County

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1831219450
  NPD

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1679674931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 W 177TH ST",
            "address_2": "UNIT 1-G",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292186",
            "telephone_number": "708-798-7400",
            "fax_number": "708-798-7503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 W 177TH ST",
            "address_2": "UNIT 1-G",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292186",
            "telephone_number": "708-798-7400",
            "fax_number": "708-798-7503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON-MONTGOMERY",
        "first_name": "MELANIE",
        "middle_name": "ROSE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "432080709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432080709",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwatson3@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vertical Plus of Hazel Crest
• Village of Hazel Crest
• W.a.Surgical Assosc. S.C.
• Walgreen Co
• Yvonne Walker
• Jean M Watson
• Leroy Nmi Weathersby II, DDS
• Rosemare Webb
• Jeremy Carter Welch, P.T.A.
• Wellness Integrative Medicine Inc

• Dentist in Hazel Crest, IL
• Providers in Hazel Crest, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.

Verify at the official NPI Registry.