Edgardo Montes Zetino, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

063860 Issued in NY

Practice address

4 Commerce LN
Canton, NY 13617-3739

Phone

(315) 386-8191

NPI assigned

Jul 6, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1831685452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3835",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981243835",
            "telephone_number": "206-548-3114",
            "fax_number": "206-762-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 COMMERCE LN",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136173739",
            "telephone_number": "315-386-8191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9245 Rainier Ave S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981185569",
            "country_code": "US",
            "telephone_number": "206-461-6981",
            "fax_number": "206-461-8581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTES ZETINO",
        "first_name": "EDGARDO",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-06",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "RR60865273",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "063860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melchiore Buscemi, MD PC
• Deanna L. Michaud, R.N.
• Kristin Miller, FNP
• Debra A Mitchell, LCSWR
• Billie Jo Monroe, LPN
• Bryan J Moore
• Angela M Morley, RN, BSN,CHN
• Morning Joy LLC
• Colleen G. Murphy, COTA
• Emilie Rose Murphy, CCC-SLP/TSSLD

• Dentist in Canton, NY
• Providers in Canton, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.