Healthcare Provider Details

I. General information

NPI: 1093554420
Provider Name (Legal Business Name): DR. ESTEFANY MONTANA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2024
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 N MIAMI BEACH BLVD
NORTH MIAMI BEACH FL
33162-3701
US

IV. Provider business mailing address

870 W 36TH ST
HIALEAH FL
33012-5164
US

V. Phone/Fax

Practice location:
  • Phone: 305-907-2186
  • Fax:
Mailing address:
  • Phone: 786-768-6499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN29084
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: