Tyrus Gerard Montgomery, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11713 Issued in MD

Practice address

12300 Kemmerton LN
Bowie, MD 20715-2721

Phone

(301) 262-1888

Fax

(301) 262-1899

NPI assigned

May 1, 2007

Last updated

Mar 18, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tmontgomery855867@direct.umm.edu

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.

• Silverspoon Dental and Associates

  • Dentist
  • Bowie, MD
  • NPI 1740143189
  NPD Authorized official
• Silverspoon Dental and Associates

  • Dentist
  • Bowie, MD
  • NPI 1962365288
  NPD Authorized official
• Affordable Dental Care Center

  • General Practice Dentistry
  • Clinton, MD
  • NPI 1619004108
  NPD (past) Authorized official

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1871714766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12300 KEMMERTON LN",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207152721",
            "telephone_number": "301-262-1888",
            "fax_number": "301-266-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12300 KEMMERTON LN",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207152721",
            "telephone_number": "301-262-1888",
            "fax_number": "301-262-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "TYRUS",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "11713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Momentum Behavioral Health Consultants and Parent Coaching
• Maryrose Ijeoma Moneke
• Mallaury Ketsia Monny Moukoko
• Denise Montgomery, LICSW, LCSW-C, LMFT
• Francesca Alexis Montgomery, LCPC
• Dorette Epse Fongoh Monthe
• Charisma Monts
• Kendall L. Moody, PHD, LCSW
• Syreeta S Moody, LCPC
• Antoinette Yvonne Moon, LCSW-C

• General Practice Dentistry in Bowie, MD
• Providers in Bowie, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.