Active NPI
Monte Paul Williams, DDS
- General Practice Dentistry
- Twin Falls, ID
National Provider Identifier
1831294164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D-3168
- Practice address
- 174 Ash Street North
Twin Falls, ID 83301-5232 - Phone
- (208) 734-3148
- Fax
- (208) 736-3907
- NPI assigned
- Sep 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D-3168 | ID | Primary |
Addresses
Primary practice location
174 Ash Street North
Twin Falls, ID 83301-5232
Mailing address
174 Ash Street North
Twin Falls, ID 83301-5232
Phone (208) 734-3148
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000932300 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161112000398 | ID | Order and Referring Only - Dentist | 0345236634 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-3168 | ID | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sage View Dental Inc | Current | Accepting new patients |
Locations
174 Ash St N
Twin Falls, ID 83301
Phone (208) 734-3148
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702598400000",
"number": "1831294164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "174 ASH STREET NORTH",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833015232",
"telephone_number": "208-734-3148",
"fax_number": "208-736-3907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "174 ASH STREET NORTH",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833015232",
"telephone_number": "208-734-3148",
"fax_number": "208-736-3907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "MONTE",
"middle_name": "PAUL",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2023-12-15",
"certification_date": "2023-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ID",
"license": "D-3168",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000932300",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.