NPIMap

Organization Active NPI

Northern Montana Oral / Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Great Falls, MT
National Provider Identifier
1962671370
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
1907 Issued in MT
Legal business name
NORTHERN MONTANA ORAL / MAXILLOFACIAL SURGERY
Practice address
2714 15TH Ave S
Great Falls, MT 59405-5246
Phone
(406) 727-4322
Fax
(406) 771-1516
NPI assigned
Feb 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2009

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

Authorized official

Name
Dr. Ronald E Neal, DDSNPI 1104934314
Title
Owner
Phone
(406) 727-4322

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 1907 MT Primary

Addresses

Primary practice location

2714 15TH Ave S
Great Falls, MT 59405-5246

Mailing address

2714 15TH Ave S
Great Falls, MT 59405-5246
Phone (406) 727-4322

Other identifiers 4

IdentifierTypeStateIssuer
1972611101MedicaidMT
5513100OtherMTCHIPS
1104934314MedicaidMT
5513092OtherMTCHIPS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1962671370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2714 15TH AVE S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055246",
            "telephone_number": "406-727-4322",
            "fax_number": "406-771-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2714 15TH AVE S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055246",
            "telephone_number": "406-727-4322",
            "fax_number": "406-771-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MONTANA ORAL / MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-29",
        "last_updated": "2009-05-12",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-727-4322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MT",
            "license": "1907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972611101",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIPS",
            "identifier": "5513100",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104934314",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIPS",
            "identifier": "5513092",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.