Montrose Dental Clinic PC

Primary specialty

DentistTaxonomy code 122300000X

License

019025991 Issued in IL

Legal business name

MONTROSE DENTAL CLINIC PC

Practice address

3541 W. Montrose Ave
Unit 1W
Chicago, IL 60618

Phone

(773) 463-8000

Fax

(773) 463-8001

NPI assigned

Jul 2, 2009

Last updated

Jul 2, 2009By 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

David Fang, DDS

Title

Dentist

Phone

(773) 969-0198

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246492800000",
    "number": "1912136623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3541 W. MONTROSE AVE",
            "address_2": "UNIT 1W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60618",
            "telephone_number": "773-463-8000",
            "fax_number": "773-463-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3541 W. MONTROSE AVE",
            "address_2": "UNIT 1W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60618",
            "telephone_number": "773-463-8000",
            "fax_number": "773-463-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTROSE DENTAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-02",
        "last_updated": "2009-07-02",
        "status": "A",
        "authorized_official_last_name": "FANG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "773-969-0198",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019025991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deepa Bhatt Montoya, DPM
• Raymond R Montoya II, DPM
• Sonia E Montoya, RDH
• Taryn Rae Montoya, MSPT, PT
• Montrose Dental Clinic PC
• Montrose Dental Group P.C.
• Montrose Family Dental Center (Edward G. Vivit, DDS)
• Montrose Foot and Ankle LLC
• Kirstin Montsma
• Priscilla Nwamy Monu, MS,RD,LDN

• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2009; 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.