Connie L Small, DDS, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1758 Issued in MT

Legal business name

CONNIE L SMALL, DDS, PLLC

Practice address

673 1St Avenue West N
Kalispell, MT 59901-3607

Phone

(406) 755-4127

NPI assigned

May 3, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Connie L Small, DDSNPI 1164508123

Title

Owner

Phone

(406) 755-4127

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Connie L Small DDS PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dr. Connie Small

  • Dentist
  • Kalispell, MT
  • NPI 1558507855
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Connie L Small, DDS

  • General Practice Dentistry
  • Kalispell, MT
  • NPI 1164508123
  NPD (past) Authorized official

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861614182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 1ST AVENUE WEST N",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013607",
            "telephone_number": "406-755-4127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "673 1ST AVENUE WEST N",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013607",
            "telephone_number": "406-755-4127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNIE L SMALL, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMALL",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-755-4127",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "1758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112115",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0115124",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Community Medical Services Montana-Private, LLC (Community Medical Services)
• Jade Como
• Robert Joseph Confessore, PH.D.
• Brady James Conner, PHARMD
• Sheila Mary Conners, OTR-L
• Carrie Elizabeth Corbett, L.M.
• Core Physical Therapy LLC
• Gregory R Cornell, LCPC
• Cornerstone Caregiving West LLC
• Cheyenne Corpron, SWLC, LAC

• General Practice Dentistry in Kalispell, MT
• Providers in Kalispell, MT by specialty
• General Practice Dentistry in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.