NANCY MONTGOMERY, D.M.D - NPI NUMBER 1538200282

Summary

Provider Name: NANCY MONTGOMERY, D.M.D

NPI Number: 1538200282

Clasification: Dentist (1223P0221X)

Specialization: Pediatric Dentistry

Address:
225 IMPERIAL BLVD
LAKELAND, FL
ZIP 33803

Phone Number: (863) 644-4739



Detailed Information

Nancy Montgomery, D.M.D is a pediatric dentistry dentist in Lakeland, FL. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. The assigned NPI number for this provider is 1538200282 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business address is:

225 IMPERIAL BLVD
LAKELAND, FL
ZIP 33803-612
Phone: (863) 644-4739
Fax: (863) 619-8680

The enumeration date for this NPI number is 2/8/2007 and was last updated on 3/5/2013.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 1223P0221X Dentist Pediatric Dentistry DN12365 FL Yes

NPI Record

No. Field Name Field Value
1 NPI 1538200282
2 Entity Type Code 1
3 Provider Last Name Legal Name MONTGOMERY
4 Provider First Name NANCY
5 Provider Credential Text D.M.D
6 Provider First Line Business Practice Location Address 225 IMPERIAL BLVD
7 Provider Business Practice Location Address City Name LAKELAND
8 Provider Business Practice Location Address State Name FL
9 Provider Business Practice Location Address Postal Code 338034612
10 Provider Business Practice Location Address Country Code If outside U S US
11 Provider Business Practice Location Address Telephone Number 8636444739
12 Provider Business Practice Location Address Fax Number 8636198680
13 Provider Enumeration Date 2/8/2007
14 Last Update Date 3/5/2013
15 Provider Gender Code F
16 Healthcare Provider Taxonomy Code 1 1223P0221X
17 Provider License Number 1 DN12365
18 Provider License Number State Code 1 FL
19 Healthcare Provider Primary Taxonomy Switch 1 Y
20 Is Sole Proprietor Y

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This page was last updated on: 10/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.