Roberto Edgardo Monteagudo, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

WI4186 Issued in WI

Practice address

1469 S 70TH St
West Allis, WI 53214-4814

Phone

(414) 383-5833

Fax

(414) 383-0233

NPI assigned

Apr 18, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Emergency Dental of Milwaukee, LLC

  • General Practice Dentistry
  • West Allis, WI
  • NPI 1295185981
  NPD (past) Authorized official
• Orchard Dental SC

  • Dental Clinic/Center
  • West Allis, WI
  • NPI 1316335763
  NPD (past) Authorized official

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750507356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1469 S 70TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532144814",
            "telephone_number": "414-383-5833",
            "fax_number": "414-383-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1469 S 70TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532144814",
            "telephone_number": "414-383-5833",
            "fax_number": "414-383-0233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEAGUDO",
        "first_name": "ROBERTO",
        "middle_name": "EDGARDO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "WI4186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Ann Mokrohisky, MD
• Molina Healthcare of Wisconsin
• Brittaney Molina, LPC
• Melissa Molitor, PTA
• Elizabeth Montcalm
• Jody Montgomery, RD
• Jeffrey Montoya, LMT
• Angela Nicole Monzon, APNP, MSN, FNP-BC
• Elizabeth Kruser Moore, PT
• Isabel Moore

• General Practice Dentistry in West Allis, WI
• Providers in West Allis, WI by specialty
• General Practice Dentistry in Wisconsin

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.