DR. EDWIN GONZALEZ MONTOYA (NPI# 1396255097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396255097 |
Entity Type | Individual |
Full Name | DR. EDWIN GONZALEZ MONTOYA |
Credential | OMFS |
Practice Address |
6585 E State St Rockford IL 61108-2542 |
Mailing Address |
3618 Elmira Ave Mcallen TX 78503-7724 |
Practice Telephone | 7875879675 |
Mailing Telephone | 7875879675 |
Enumeration Date | 2017-10-07 |
Last Update Date | 2017-12-07 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 122300000X | Dentist | 019031410 | IL | Dental Providers |
N | 1223G0001X |
Dentist Specialization: General Practice |
019031410 | IL | Dental Providers |
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
021002849 | IL | Dental Providers |
Street Address |
6585 E STATE ST |
City | ROCKFORD |
State | IL |
Zip Code | 61108-2542 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952862617 | Isr Enterprises, Inc. | Homemaker | 129 Phelps Ave, Bldg 10, Ste 1008, Rockford, IL 61108 | 2019-03-26 |
1003306465 | Adrienne Nicole Black | Behavior Technician | 519 Woodland Dr, Woodland Dr, Rockford, IL 61108 | 2018-05-11 |
1184085201 | Integrative Healing Center, LLC | Clinic/Center | 6019 Fincham Drive, Rockford, IL 61108 | 2016-03-17 |
1730547936 | Perryville Dentist PC | Dentist | 845 S Perryville Rd, Unit 119, Rockford, IL 61108 | 2016-02-02 |
1023489853 | Nicole Ping Ticknor | Counselor | 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 | 2015-10-20 |
1275940348 | Northwest Home Care, Inc. | Home Health | 1437 S. Bell School Road, Suite 7, Rockford, IL 61108 | 2014-07-21 |
1487072922 | Alecia Greenlee | Psychiatry & Neurology | Rosecrance Community Mental Health, 3815 Harrison Avenue, Rockford, IL 61108 | 2014-04-02 |
1871925446 | Maria Laura Gustafson | Interpreter | 3208 Wesleyan Ave., Rockford, IL 61108 | 2013-08-06 |
1346582822 | Joseph Peevey | Pathology | 5666 E State Street, Department of Pathology, Rockford, IL 61108 | 2013-03-21 |
1134466923 | James Henry Peck | Hearing Instrument Specialist | 2424 Charles St, Rockford, IL 61108 | 2013-01-14 |
Find all providers in zip 61108 |
Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952887374 | Winnebago Braces, LLC. | Dentist | 555 N Court St Ste 110, Rockford, IL 61103-6898 | 2018-07-18 |
1811374945 | Alexandria Hawkins | Dentist | 6050 Brynwood Dr Ste 102, Rockford, IL 61114-6579 | 2015-04-27 |
1003977224 | Edward Paul Rentschler | Dentist | 449 Roxbury Road, Rockford, IL 61107 | 2006-12-12 |
1346318532 | Michael Degould Dds PC | Dentist | 2835 Mcfarland Road, Suite C, Rockford, IL 61107 | 2006-12-04 |
1134127491 | David A. Francis Iv | Dentist | 4035 Morsay Dr, Rockford, IL 61107-4871 | 2005-07-11 |
1225574775 | Swedishamerican Hospital | Dentist | 425 Roxbury Rd, Rockford, IL 61107 | 2017-01-09 |
1245673441 | Michael David Degould | Dentist | 2835 Mcfarland Rd, Suite C, Rockford, IL 61107-6819 | 2013-04-08 |
1538394580 | Matthew James Bruksch | Dentist | 449 Roxbury Road, Rockford, IL 61107 | 2009-05-20 |
1992975551 | Edward P. Rentschler Dds, PC | Dentist | 425 Roxbury Rd, Rockford, IL 61107-5075 | 2008-03-10 |
1598805822 | Kurt Fredric Jensen | Dentist | 6050 Brynwood Dr, Ste 102, Rockford, IL 61114-6579 | 2007-02-07 |
Find all providers in ROCKFORD |
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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.