Alan B Montgomery, D.D.S, M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D8584 Issued in MN

Practice address

4535 Hodgson Rd
#700
Shoreview, MN 55126-1949

Phone

(651) 765-1945

Fax

(651) 765-1949

NPI assigned

Dec 16, 2009

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1770812018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 HODGSON RD",
            "address_2": "#700",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551261949",
            "telephone_number": "651-765-1945",
            "fax_number": "651-765-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 HODGSON RD",
            "address_2": "#700",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551261949",
            "telephone_number": "651-765-1945",
            "fax_number": "651-765-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "ALAN",
        "middle_name": "B",
        "credential": "D.D.S, M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-16",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "D8584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI ENUMERATOR, TYPE 2 NPI",
            "identifier": "176058321",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Salim Ali Mohamed
• Sumey Omar Mohamed
• Sucdi Mohamud
• Momentum Wellness Partners
• Matthew C Monteiro, MD
• Elaine Moore, MA, LP
• Rebecca Moos
• Hayley Mordorski, PHARM.D
• Michael Roy Morris, MS, LPCC
• Mariah Lynn Moskalik, RN

• Orthodontics and Dentofacial Orthopedics Dentistry in Shoreview, MN
• Providers in Shoreview, MN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; 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.