Enrique Fernandez Montes

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4092C Issued in AS

Practice address

#1 Petesa Rd
Pago Pago, AS 96799

Phone

(684) 699-6380

NPI assigned

Nov 11, 2021

Last updated

Nov 11, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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

{
    "created_epoch": "1636588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1932865292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 998375",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "967996314",
            "telephone_number": "684-256-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#1 PETESA RD",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "96799",
            "telephone_number": "684-699-6380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTES",
        "first_name": "ENRIQUE",
        "middle_name": "FERNANDEZ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-11",
        "last_updated": "2021-11-11",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AS",
            "license": "4092C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roner Rivera Mendoza, MD
• Miner Audiology, LLC
• Miner Audiology, LLC
• Raymond Michael Miner, CCC-A
• Faasegia Moananu-Sala, TCT
• Bethel T. Muasau-Howard, MBBS
• Jasmine Julliam Muasau, MBBS
• Rose Orisia Naesol, MBBS PGDIPEM MMEDEM
• Ifereimi B Naiviqa, BDS
• Take Kolisi Naseri

• General Practice Dentistry in Pago Pago, AS
• Providers in Pago Pago, AS by specialty
• General Practice Dentistry in American Samoa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.