Monument Dental PC

Primary specialty

DentistTaxonomy code 122300000X

License

2901021011 Issued in MI

Legal business name

MONUMENT DENTAL PC

Practice address

15510 Livernois Avenue
Detroit, MI 48238

Phone

(313) 863-2800

Fax

(313) 341-7867

NPI assigned

Oct 29, 2014

Organization subpart

No

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

Authorized official

Name

Donna Marie Kirchner

Title

Insurance Manager

Phone

(586) 915-0107

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431388800000",
    "number": "1760887020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15510 LIVERNOIS AVENUE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48238",
            "telephone_number": "313-863-2800",
            "fax_number": "313-341-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15510 LIVERNOIS AVENUE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48238",
            "telephone_number": "313-863-2800",
            "fax_number": "313-341-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONUMENT DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-29",
        "last_updated": "2015-05-12",
        "status": "A",
        "authorized_official_last_name": "KIRCHNER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "586-915-0107"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2901021011",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zelda Montgomery
• Nicole Rose Monti, DNP, APRN, FNP-BC
• Kristofer Montoya, MD
• Peter Montrie, CRNA
• Joyce Ann Monts, RN
• Kaya Moody
• Laraine Yakowich Moody, NP
• Melissa Moody
• Qua-Terriance Moody
• Tracey L Mooer

• Dentist in Detroit, MI
• Providers in Detroit, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; 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.