Individual provider Active NPI

John Montoya

  • Dentist
  • Boulder, CO
National Provider Identifier
1942458328
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9350 Issued in CO
Practice address
4770 Baseline Rd Ste 310
Boulder, CO 80303
Phone
(303) 443-1895
NPI assigned
Aug 28, 2008
Last updated
Feb 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9350 CO Primary

Addresses

Primary practice location

4770 Baseline Rd Ste 310
Boulder, CO 80303

Mailing address

4770 Baseline Rd Ste 310
Boulder, CO 80303-2669
Phone (303) 443-1895

Other practice location 1

4770 Baseline Rd Ste 310
Boulder, CO 80303
Phone (303) 443-1895

Other identifiers 1

IdentifierTypeStateIssuer
1629239827OtherCONPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200302001025 CO Order and Referring Only - DentistPractitioner - Dentist 8022445188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9350COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
John Montoya DDS PC Dentist CurrentSince Aug 1, 2008 Accepting new patients
John Montoya DDS PC Dentist Current Accepting new patients

Locations

2500 30th St
Ste 120
Boulder, CO 80301
Phone (303) 443-1895

4770 Baseline Rd
Ste 310
Boulder, CO 80303
Phone (303) 443-1895

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1942458328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 BASELINE RD STE 310",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032669",
            "telephone_number": "303-443-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 BASELINE RD STE 310",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80303",
            "telephone_number": "303-443-1895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4770 Baseline Rd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "80303",
            "country_code": "US",
            "telephone_number": "303-443-1895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTOYA",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-28",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "9350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1629239827",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.