DR. MARK R MONTGOMERY (NPI# 1548486905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548486905 |
| Entity Type | Individual |
| Full Name | DR. MARK R MONTGOMERY |
| Credential | DDS |
| Practice Address |
130 W Jackson St Cicero IN 46034 |
| Mailing Address |
Po Box 375 Cicero IN 46034-0375 |
| Practice Telephone | 3179843000 |
| Practice Fax Number | 3179843000 |
| Mailing Telephone | 3179843000 |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2018-05-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 12008126A | IN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100211710 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851478564 | Mark Alyn Montgomery | Counselor | 4554 E. Inverness Ave., C-108, Mesa, AZ 85206-4639 | 2006-11-01 |
| 1306261367 | Mark Montgomery | Pharmacy Technician | 1149 University Dr, Burlington, NC 27215-8798 | 2014-02-28 |
| 1518152610 | Mark Alan Montgomery | Counselor | 1011 W 31st St, Suite 24, Austin, TX 78705-2099 | 2007-09-11 |
| 1043413024 | Mark N. Montgomery | Dentist | 32241 Crown Valley Pkwy, Suite 240, Monarch Beach, CA 92629-3346 | 2007-06-07 |
| 1558424309 | Mark Woodrow Montgomery | Dentist | 925 Commercial St Se, Suite 240, Salem, OR 97302 | 2006-12-19 |
| 1528012655 | Mark Harlow Montgomery | Otolaryngology | 9240 Bonita Beach Rd, Suite 1106, Bonita Springs, FL 34135-4249 | 2006-05-22 |
| 1366403347 | Mark L. Montgomery | Radiology | 2401 S 31st St, Temple, TX 76508-0001 | 2006-03-30 |
| Street Address |
130 W JACKSON ST |
| City | CICERO |
| State | IN |
| Zip Code | 46034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689710170 | Thomas Jerry Elliott Sr. | Dentist | 17 West Jackson St., Cicero, IN 46034 | 2007-01-30 |
| 1144285719 | Mary Angela Shirley | Social Worker | 209 S Peru St, Ste 210-211, Cicero, IN 46034 | 2006-04-18 |
| 1164486601 | Nancy Leah Shirley | Social Worker | 209 S Peru Street, Suite 210 211, Cicero, IN 46034 | 2006-04-13 |
| 1700867827 | Richard Edward Hayes | Family Medicine | 1160 S. Peru Street, S.r. 19, Cicero, IN 46034 | 2005-11-07 |
| 1306251897 | Jon Purkey | Specialist/Technologist | 230 Washington Avenue, Cicero, IN 46034-0321 | 2014-06-24 |
| 1477836070 | Myrtie B Mays | Specialist | 22345 Schulley Rd, Cicero, IN 46034-8800 | 2011-09-21 |
| 1609002724 | Hoosier Dentures & Dental Surgery, LLC | Clinic/Center | 1200 S Peru St, Cicero, IN 46034-9161 | 2009-06-03 |
| 1710549142 | Julie Baber | Technician | 1180 Coral Springs Dr, Cicero, IN 46034-9214 | 2019-07-05 |
| 1669592572 | Shelley Kunkel | Developmental Therapist | 1215 Coral Springs Dr, Cicero, IN 46034-9217 | 2007-04-02 |
| 1467572297 | Allison Labrie | Specialist | 1010 W Morse Dr, Cicero, IN 46034-9238 | 2007-03-29 |
| Find all providers in zip 46034 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356837512 | Jennifer Lonnen Dds Pllc | Dentist | 6221 Rt 31 Ste 102, Cicero, NY 13039 | 2018-07-10 |
| 1386090397 | Kristin Raineri | Dentist | 5972 Rt 31, Cicero, NY 13039 | 2016-05-09 |
| 1982942124 | Seada G. Damiano | Dentist | 5972 State Route 31, Cicero, NY 13039-8941 | 2013-01-23 |
| 1982956249 | Sby Dds PC | Dentist | 5315 W Cermak Rd, Cicero, IL 60804-2817 | 2012-10-11 |
| 1194976282 | Perfect Dental Smile, Ltd | Dentist | 6017 W Cermak Rd, Cicero, IL 60804-2018 | 2008-10-07 |
| 1295935369 | Sinan A Razzak | Dentist | 3020 S Cicero Ave, Cicero, IL 60804-3638 | 2007-07-18 |
| 1942421292 | Daniel Quiros | Dentist | 6195 State Route 31, Suite 10, Choice Family Dentistry & Dentures, Cicero, NY 13039 | 2007-05-02 |
| 1699820837 | Sherin B Jacob | Dentist | 4939 W 14th St, Cicero, IL 60804-1419 | 2007-01-25 |
| 1073668380 | Amee Soni | Dentist | 5539 W Cermak Rd, Cicero, IL 60804-2218 | 2007-01-24 |
| 1851458681 | Patricia Eileen Romano | Dentist | 5962 State Route 31, Cicero, NY 13039-8800 | 2007-01-02 |
| Find all providers in CICERO | ||||
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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.