Individual provider Active NPI

Monte Paul Williams, DDS

  • General Practice Dentistry
  • Twin Falls, ID
National Provider Identifier
1831294164
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-3168 Issued in ID
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

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
000932300MedicaidID

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161112000398 ID Order and Referring Only - DentistPractitioner - Dentist 0345236634

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D-3168IDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sage View Dental Inc CurrentSince Dec 17, 2023 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

Verify at the official NPI Registry.