Constanza Montejo-Kadera, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

54018 Issued in CA

Practice address

3110 Kerner Blvd
San Rafael, CA 94901-5411

Phone

(415) 526-8559

Fax

(415) 526-8556

NPI assigned

Feb 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: ckadera585042@direct.ochin.org

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1992846430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 KERNER BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949015411",
            "telephone_number": "415-526-8559",
            "fax_number": "415-526-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 KERNER BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949015411",
            "telephone_number": "415-526-8559",
            "fax_number": "415-526-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEJO-KADERA",
        "first_name": "CONSTANZA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "54018",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Garnache DMD Inc
• John Monkhouse
• Monroe Operations LLC
• Monroe Operations, LLC
• Marlena Montano
• Justin Montello
• Sobeyda M Monterroso Ramirez, RD
• Marci Nicole Montes, O.T.R.L.
• Monica Marie Montury
• Logan Moody

• General Practice Dentistry in San Rafael, CA
• Providers in San Rafael, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; 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.