MONTGOMERY RADIOGRAPHIC SVS (NPI# 1316151202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316151202 |
| Entity Type | Organization |
| Organization Name | MONTGOMERY RADIOGRAPHIC SVS |
| Practice Address |
720 N Tustin Ave Ste 204 Santa Ana CA 92705-3606 |
| Mailing Address |
720 N Tustin Ave 204 Santa Ana CA 92705 |
| Practice Telephone | 7148357260 |
| Practice Fax Number | 7148355808 |
| Mailing Telephone | 7148357260 |
| Mailing Fax Number | 7148355808 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MONTE MATTHEW MONTGOMERY (OWNER XRAY TECHNICIAN) |
| Authorized Official Telephone | 7148357260 |
| Authorized Official Credential | XRAY TECHNICIAN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0008X |
Dentist Specialization: Oral and Maxillofacial Radiology |
RHP 52036 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PROVIDER NUMBER | CGP168497 | 01 |
| Street Address |
720 N TUSTIN AVE STE 204 |
| City | SANTA ANA |
| State | CA |
| Zip Code | 92705-3606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952919763 | John G. Alevizos, D.o., A Professional Medical Corporation | Preventive Medicine | 1530 East Edinger Avenue, Suite 1, Santa Ana, CA 92705 | 2020-07-17 |
| 1477186625 | Joyce Altman Interpreters, Inc. | Interpreter | 1971 East 4th Street, Ste 206, Santa Ana, CA 92705 | 2020-02-17 |
| 1588214688 | Cindy Mejia | Behavior Technician | 505 N. Tustin Ave., #152, Santa Ana, CA 92705 | 2019-09-19 |
| 1588210504 | Jennifer Ang Lim-quevedo | Nurse Practitioner | 18362 Whitney Dr, Santa Ana, CA 92705 | 2019-08-15 |
| 1962056820 | Melinda Acosta Black | Social Worker | 1526 Brookhollow Drive, Santa Ana, CA 92705 | 2019-07-30 |
| 1972069631 | Amy Marie Elit | Nurse Practitioner | 1751 E Harry Ave, Santa Ana, CA 92705 | 2019-02-18 |
| 1386118180 | Unified Behavioral Health, LLC | Substance Abuse Rehabilitation Facility | 1218 W Santa Ana Blvd, Santa Ana, CA 92705 | 2019-01-15 |
| 1952884736 | Javier Perales | Social Worker | 1652 Windsor Ln, Santa Ana, CA 92705 | 2018-09-08 |
| 1073009700 | Eva E Kuncewicki | Marriage & Family Therapist | 1001 S Grand Ave # B, Santa Ana, CA 92705 | 2018-07-05 |
| 1487149886 | Nimbus Medtransport Inc. | Non-emergency Medical Transport (VAN) | 2112 E 4th St Ste 235, Santa Ana, CA 92705 | 2018-06-27 |
| Find all providers in zip 92705 | ||||
| Taxonomy Code | 1223X0008X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Radiology |
| The specialty of dentistry and discipline of radiology concerned with the production and interpretation of images and data produced by all modalities of radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700350485 | Katya Archambault | Dentist | 9245 Regents Rd Unit M208, La Jolla, CA 92037-9266 | 2019-01-16 |
| 1609101120 | Louis T Kircos | Dentist | 666 3rd St, Suite 222, San Rafael, CA 94901-3356 | 2009-10-16 |
| 1528200045 | Judy Janette Hurt | Dentist | 2920 F St Ste B2, Bakersfield, CA 93301-1829 | 2009-03-30 |
| 1780833087 | Shaza Mardini | Dentist | 2745 Via Villaggio, Sacramento, CA 95864-3788 | 2008-09-11 |
| 1134253339 | Loma Linda University | Dentist | 11092 Anderson Street, Loma Linda, CA 92354 | 2007-03-16 |
| 1679580575 | Stuart C. White | Dentist | 10833 Le Conte Ave. Chs 10-165, Los Angeles, CA 90095-1668 | 2006-08-02 |
| 1396195483 | Shikha Rathi- Raythatha | Dentist | 2110 Professional Dr, Suite 101, Roseville, CA 95661-3752 | 2016-06-20 |
| 1366575490 | Francis H. Chung, Dds, Inc | Dentist | 2460 Mission St, Suite #109, San Francisco, CA 94110-2430 | 2007-03-14 |
| 1356476865 | Regents of University of California | Dentist | 10833 Le Conte Ave, Chs 10 -165, Los Angeles, CA 90095-1668 | 2007-02-23 |
| 1538247754 | Sotirios Tetradis | Dentist | 10833 Le Conte Ave, Chs 10-165, Los Angeles, CA 90095-1668 | 2006-11-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.