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Stacey Montano DDS LLC

Clinic/Center, Dental in Albuquerque, NM. Organization (NPI-2).

NPI number1124512488
StatusActive
Last updated in NPPESJun 20, 2018

Details

NPI
1124512488
Entity type
Organization (NPI-2)
Legal business name
Stacey Montano DDS LLC
Organization subpart
No
Enumeration date
Jun 20, 2018
Last updated
Jun 20, 2018

Medicare and OIG

Medicare enrolled (PECOS)
Not in the Medicare enrollment file
Can order and refer
Not on the CMS order and referring list
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QD0000X Clinic/Center, DentalDD3304NMYes

Practice location

3901 Georgia St Ne Ste G1
Albuquerque, NM 87110-1388

Phone 505-888-3112

Mailing address

3901 Georgia St Ne Ste G1
Albuquerque, NM 87110-1388

Phone 505-888-3112

Authorized official

Stacey Montano
Dentist/Owner
5058883112

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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