NPIMap

Organization Active NPI

Roundup Family Dentistry

  • Dental Clinic/Center
  • Roundup, MT
National Provider Identifier
1700522398
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
ROUNDUP FAMILY DENTISTRY
Practice address
239 Main St
Roundup, MT 59072-2735
Phone
(406) 323-1234
NPI assigned
May 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Authorized official

Name
Dr. Jack Daigrepont, DDSNPI 1467801068
Title
General Dentist
Phone
(406) 323-1234

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

239 Main St
Roundup, MT 59072-2735

Mailing address

239 Main St
Roundup, MT 59072-2735
Phone (406) 323-1234

Other identifiers 1

IdentifierTypeStateIssuer
146801068MedicaidMT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1651881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652400000000",
    "number": "1700522398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 MAIN ST",
            "city": "ROUNDUP",
            "state": "MT",
            "postal_code": "590722735",
            "telephone_number": "406-323-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 MAIN ST",
            "city": "ROUNDUP",
            "state": "MT",
            "postal_code": "590722735",
            "telephone_number": "406-323-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROUNDUP FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-07",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A",
        "authorized_official_last_name": "DAIGREPONT",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "406-323-1234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146801068",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roundup, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; 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.