Provider Demographics
NPI:1619695152
Name:MONTEMAYOR, CASSANDRA JUDITH (DDS)
Entity Type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:JUDITH
Last Name:MONTEMAYOR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CASSANDRA
Other - Middle Name:JUDITH
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1205 SAVANNAH DR
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-2923
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1205 SAVANNAH DR
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-2923
Practice Address - Country:US
Practice Address - Phone:210-659-9001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-19
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX385151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice