NPIMap

Organization Active NPI

Dentists of Montgomery, PC

Doing business as Dentists of Montgomery

  • Dentist
  • Montgomery, TX
National Provider Identifier
1750892782
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DENTISTS OF MONTGOMERY, PC
Doing business as
Dentists of Montgomery
Practice address
20042 Eva St Ste 100
Montgomery, TX 77356-2017
Phone
(936) 206-7069
Fax
(936) 206-7069
NPI assigned
Oct 17, 2017
Last updated
Feb 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Authorized official

Name
Dr. James De-Vera, DDS
Title
Owner
Phone
(936) 206-7069

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

20042 Eva St Ste 100
Montgomery, TX 77356-2017

Mailing address

PO Box 920050
Dallas, TX 75392-0050
Phone (714) 845-8500

Other names 1

  • Dentists of Montgomery Doing business as

National Provider Directory

National Provider Directory

Locations

20042 Eva St
Ste 100
Montgomery, TX 77356
Phone (936) 206-7069

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1750892782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8500",
            "fax_number": "303-952-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20042 EVA ST STE 100",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773562017",
            "telephone_number": "936-206-7069",
            "fax_number": "936-206-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTS OF MONTGOMERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-17",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "DE-VERA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-206-7069",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentists of Montgomery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montgomery, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.