Individual provider Active NPI

Sandra Montes, DDS

  • General Practice Dentistry
  • Bernalillo, NM
National Provider Identifier
1740695931
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DD4101 Issued in NM
Practice address
120 E Highway 550
Bernalillo, NM 87004-5967
Phone
(505) 393-5555
NPI assigned
Jun 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019030114 IL
General Practice Dentistry 1223G0001X DD4101 NM Primary

Addresses

Primary practice location

120 E Highway 550
Bernalillo, NM 87004-5967

Mailing address

120 E Highway 550
Bernalillo, NM 87004-5967
Phone (505) 393-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20150112000877 NM Order and Referring Only - DentistPractitioner - Dentist 7719201276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019030114ILMDGeneral Practice Dentistry
DD4101NMMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1740695931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E HIGHWAY 550",
            "city": "BERNALILLO",
            "state": "NM",
            "postal_code": "870045967",
            "telephone_number": "505-393-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E HIGHWAY 550",
            "city": "BERNALILLO",
            "state": "NM",
            "postal_code": "870045967",
            "telephone_number": "505-393-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTES",
        "first_name": "SANDRA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019030114",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD4101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bernalillo, NM

Sources for this page

Verify at the official NPI Registry.