Healthcare Provider Details

I. General information

NPI: 1821922915
Provider Name (Legal Business Name): CARLOS SAMUEL GOMEZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 GRAND AVE
BILLINGS MT
59102-3302
US

IV. Provider business mailing address

3681 OLIVIA DR
BILLINGS MT
59102-7666
US

V. Phone/Fax

Practice location:
  • Phone: 406-625-3000
  • Fax:
Mailing address:
  • Phone: 435-241-2904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN-DEN-LIC-33382
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: