ALEX MONTAZEM DMD NPI 1730230574

NPI Information

NPI: 1730230574
Provider Name: ALEX MONTAZEM, DMD
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

PECOS Registration: Yes

Address:
285 E MAIN ST STE 108
SMITHTOWN, NY
ZIP 11787
Phone: (631) 265-9700
Get Directions

Alex Montazem, DMD is an oral and maxillofacial surgery dentist in Smithtown, NY. The provider is an oral and maxillofacial surgery dentist specialized in 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. Alex Montazem, DMD NPI is 1730230574. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

285 E MAIN ST STE 108
SMITHTOWN, NY
ZIP 11787-912
Phone: (631) 265-9700
Fax: (631) 265-9703

The NPI 1730230574 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/16/2007 and was last updated on 6/23/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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	1223P0106X	Dentist	Oral and Maxillofacial Pathology	042730	NEW YORK	No
2	1223S0112X	Dentist	Oral and Maxillofacial Surgery	042730	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P3492579	OTHER		OXFORD
2	0565561	OTHER	NEW YORK	GHI MEDICAL
3	522421P	OTHER	NEW YORK	HIP
4	D99121	OTHER		EMPIRE BCBS
5	116561	OTHER		CIGNA DMO
6	1364282	OTHER		UNITED HEALTHCARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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